Skip to main content
Log in

Soluble endothelial cell protein C receptor and thrombomodulin levels after renal transplantation

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Background

Both thrombomodulin (TM) and endothelial protein C receptor (EPCR) are candidate biomarkers of endothelial damage and have a role of anti-thrombotic defense mechanism in vascular structure. In this study, we aimed to investigate soluble EPCR (sEPCR), soluble TM (sTM) and tumor necrosis factor-alpha (TNF-alpha) levels in hemodialysis (HD) and renal transplant (RTx) recipients.

Methods

Twenty-seven RTx recipients and 15 HD patients were recruited to the study. RTx recipients were evaluated before and 3 months after transplantation. Plasma sEPCR, sTM and TNF-alpha levels were measured at baseline and 3 months later in both groups. Moreover, 27 healthy subjects were evaluated regarding sEPCR.

Results

At baseline, there was no difference in sTM, sEPCR, TNF-alpha and C-reactive protein (CRP) between the groups. In paired analysis, sEPCR (266 ± 132 to 117 ± 72 ng/ml), sTM (635 ± 165 to 100 ± 41 ng/ml) and TNF-alpha (11.2 ± 4.3 to 6.0 ± 3.5 pg/ml) were significantly decreased in RTx patients (P < 0.0001) at 3 months, while there was no change in the HD group. In the healthy subjects, sEPCR was found to be 79 ± 26 ng/ml at baseline, which was lower than in both groups.

Conclusions

We showed that the recently proposed endothelial damage biomarkers, sTM and sEPCR, are elevated in HD patients and significantly decrease after kidney transplantation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Arend SM, Mallat MJK, Westendorp RJW, Van Der Voude FJ, Van Es LA (1997) Patient survival after renal transplantation; more than 25 years follow-up. Nephrol Dial Transplant 12:1672–1679

    Article  CAS  PubMed  Google Scholar 

  2. Cottone S, Palermo A, Vaccaro F et al (2007) Inflammation and endothelial activation are linked to renal function in long-term kidney transplantation. Transpl Int 1:82–87

    Article  Google Scholar 

  3. Kocak H, Ceken K, Yavuz A et al (2006) Effect of renal transplantation on endothelial function in haemodialysis patients. Nephrol Dial Transplant 1:203–207

    Google Scholar 

  4. Oflaz H, Turkmen A, Turgut F et al (2006) Changes in endothelial function before and after renal transplantation. Transpl Int 4:333–337

    Article  Google Scholar 

  5. Yilmaz MI, Saglam M, Carrero JJ et al (2008) Serum visfatin concentration and endothelial dysfunction in chronic kidney disease. Nephrol Dial Transplant 3:959–965

    Google Scholar 

  6. Caglar K, Yilmaz MI, Saglam M et al (2007) Endothelial dysfunction and fetuin A levels before and after kidney transplantation. Transplantation 4:392–397

    Article  Google Scholar 

  7. Yilmaz MI, Saglam M, Caglar K et al (2006) The determinants of endothelial dysfunction in CKD: oxidative stress and asymmetric dimethylarginine. Am J Kidney Dis 1:42–50

    Article  Google Scholar 

  8. Soler MJ, Martinez-Estrada OM, Puig-Mari JM et al (2005) Circulating endothelial progenitor cells after kidney transplantation. Am J Transplant 9:2154–2159

    Article  Google Scholar 

  9. Mohamed AS, Thompson J, McDonald KJ et al (2005) Circulating endothelial cells in renal transplant recipients. Transplant Proc 5:2387–2390

    Article  Google Scholar 

  10. Kurosawa S, Stearns-Kurosawa DJ, Hidari N, Esmon CT (1997) Identification of functional endothelial protein C receptor in human plasma. J Clin Invest 2:411–418

    Article  Google Scholar 

  11. Boomsma MM, Stearns-Kurosawa DJ, Stegeman CA et al (2002) Plasma levels of soluble endothelial cell protein C receptor in patients with Wegener’s granulomatosis. Clin Exp Immunol 128:187–194

    Article  CAS  PubMed  Google Scholar 

  12. Sesin C, Yin X, Esmon CT, Buyon JP, Clancy RM (2005) Shedding of endothelial protein C receptor contributes to vasculopathy and renal injury in lupus: in vivo and in vitro evidence. Kidney Int 68:110–120

    Article  CAS  PubMed  Google Scholar 

  13. Van De Wouwer M, Collen D, Conway EM (2004) Thrombomodulin-protein C-EPCR system: integrated to regulate coagulation and inflammation. Arterioscler Thromb Vasc Biol 8:1374–1383

    Article  Google Scholar 

  14. Taylor FB, Peer GT, Lockhart MS, Ferrell G, Esmon CT (2001) Endothelial cell protein C receptor plays an important role in protein C activation in vivo. Blood 6:165–168

    Google Scholar 

  15. Naumnik B, Borawski J, Pawlak K, Mysliwiec M (2002) Effect of hemodialysis on plasma levels of vascular endothelial markers. Clin Appl Thromb Hemost 3:245–250

    Article  Google Scholar 

  16. Soejima A, Kaneda F, Manno S et al (2002) Useful markers for detecting decreased serum antioxidant activity in hemodialysis patients. Am J Kidney Dis 5:1040–1046

    Article  Google Scholar 

  17. Tzanatos HA, Agroyannis B, Chondros C et al (2000) Cytokine release and serum lipoprotein (a) alterations during hemodialysis. Artif Organs 5:329–333

    Article  Google Scholar 

  18. Inuaki T, Fujiwara Y, Tayama K, Aso Y, Takemura Y (1996) Clinical significance of measurements of urinary and serum thrombomodulins in patients with non-insulin- dependent diabetes mellitus. Diabetes Res Clin Pract 2:99–104

    Article  Google Scholar 

  19. Aso Y, Inuaki T, Takemura Y (1998) Mechanisms of elevation of serum and urinary concentrations of soluble thrombomodulin in diabetic patients: possible application as a marker for vascular endothelial injury. Metabolism 3:362–365

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by Ankara University Scientific Research Project.

Conflict of interest

None declared.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kenan Keven.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Keven, K., Elmaci, S., Sengul, S. et al. Soluble endothelial cell protein C receptor and thrombomodulin levels after renal transplantation. Int Urol Nephrol 42, 1093–1098 (2010). https://doi.org/10.1007/s11255-009-9654-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-009-9654-6

Keywords

Navigation