Diabetes
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fiorina, P.
Right arrow Articles by Secchi, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fiorina, P.
Right arrow Articles by Secchi, A.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Diabetes 53:2291-2300, 2004
© 2004 by the American Diabetes Association, Inc.

Normalization of Multiple Hemostatic Abnormalities in Uremic Type 1 Diabetic Patients After Kidney-Pancreas Transplantation

Paolo Fiorina1, Franco Folli1, Armando D’Angelo2, Giovanna Finzi3, Fabio Pellegatta4, Valeria Guzzi1, Carlo Fedeli1, Patrizia Della Valle2, Luciana Usellini3, Claudia Placidi3, Francesco Bifari1, Daniela Belloni5, Elisabetta Ferrero1, Carlo Capella3, and Antonio Secchi1,6

1 Department of Internal Medicine, San Raffaele Scientific Institute, Milan, Italy
2 Coagulation Service and Thrombosis, Research Unit, San Raffaele Scientific Institute, Milan, Italy
3 Pathology Department, Università dell’Insubria, Varese, Italy
4 Istituto di Farmacologia, Milan, Italy
5 Institute of General Pathology, University of Milan, Milan, Italy
6 Universita’ Vita e Salute-San Raffaele, Milan, Italy

To evaluate the effects of kidney-pancreas transplantation on hemostatic abnormalities in uremic type 1 diabetic patients, we conducted a cross-sectional study involving 12 type 1 diabetic patients, 30 uremic type 1 diabetic patients, 27 uremic type 1 diabetic patients who had a kidney-pancreas transplant, 12 uremic type 1 diabetic patients who had a kidney-alone transplant, and 13 healthy control subjects. We evaluated platelet and clotting system. Platelets in the group of uremic type 1 diabetic patients were significantly larger than platelets in the other groups. Resting calcium levels were significantly higher in the uremic type 1 diabetic patients and uremic type 1 diabetic patients who had a kidney-alone transplant than in the type 1 diabetic patients who had a kidney-pancreas transplant and control subjects. CD41 expression was significantly reduced in platelets from the uremic type 1 diabetic patients compared with the other groups. Levels of hypercoagulability markers in the type 1 diabetic patients who had a kidney-pancreas transplant and, to a lesser extent, the uremic type 1 diabetic patients who had a kidney-alone transplant but not the uremic type 1 diabetic patients were similar to those of the control subjects. A reduction in natural anticoagulants was evident in the uremic type 1 diabetic patients, whereas near-normal values were observed in the type 1 diabetic patients who had a kidney-pancreas transplant and uremic type 1 diabetic patients who had a kidney-alone transplant. Hemostatic abnormalities were not observed in type 1 diabetic patients who had a kidney-pancreas transplant. This finding might explain the lower cardiovascular death rate observed in type 1 diabetic patients who had a kidney-pancreas transplant compared with uremic type 1 diabetic patients who had a kidney-alone transplant or uremic type 1 diabetic patients.

Address correspondence and reprint requests to Antonio Secchi, MD, Internal Medicine, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy. E-mail: antonio.secchi{at}hsr.it


Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2004 by the American Diabetes Association.