The changes of D-D, t-PA and PAI in acute renal failure patients during blood purification and its clinical significance

Objective: To study the dynamic changes and clinical significance of D-D, t-PA and PAI in patients with acute renal failure during the process of different methods of blood purification. Methods: Thirty-seven ARF patients were divided into three groups: HD group, HDF group and HF group. Plasma D-D level, t-PA and PAI activity were determined 1 hour, 4 hours before and after treatment. Normal control group consisted of fourteen healthy people. Results: Circled digit one Plasma D-D level and PAI activity in ARF patients were obviously higher than those in control group, while t-PA activity was lower(P<0.05). Circled digit two In HD group, the plasma D-D level and PAI activity increased continuously, while t-PA activity decreased during the therapy process; moreover, there were significant differences in the different therapy time segments(P<0.05). In HDF and HF groups, D-D level and PAI activity increased at first, and then decreased, but the changes of t-PA activity were just opposite to these two. No significant differences were found in the different therapy time segments(P>0. 05). Circled digit three After 4 hours of the treatment, compared with HD group, HDF and HF groups had significant difference in plasma D-D level, t-PA and PAI activity(P<0.05). Conclusion: There was a disorder of coagulation and fibrinolysis system in ARF patients, and HD can aggravate these changes. HDF or HF may decrease these changes and improve the clinic effects.