The significance of fibrinogen derivatives in plasma in human renal failure

Abstract

Summary. The concentrations in plasma of fibrinogen derivatives fibrinopeptide A (FPA), β 15–42 antigen and fragment E (FgE) antigen have been determined in patients with renal failure and compared to the concentrations of the platelet release products, β‐thromboglobulin (βTG) and platelet factor 4 (PF4). In ‘partial renal failure’(⁵¹Cr‐EDTA clearance rate 4–60 ml/min) FPA, β 15–42 antigen, FgE antigen and βTG levels were significantly raised above a normal laboratory control group. These levels were further raised in a group of patients whose disease required regular maintenance haemodialysis (⁵¹Cr‐EDTA clearance rate < 4 ml/min). PF4 levels were not significantly raised in either group. A statistical analysis of all patient results revealed that FPA, β 15–42 antigen and FgE antigen levels all correlated with βTG levels but not with PF4 levels. It is known that βTG is catabolized by the kidney but PF4 is not and that elevated βTG levels in renal failure are caused by impaired elimination rather than increased production. These results suggest that the plasma levels of these three fibrinogen derivatives are elevated in renal disease at least in part by decreased elimination rather than by increased thrombin and plasmin activities alone.