Normalization of multiple hemostatic abnormalities in uremic type 1 diabetic patients after kidney-pancreas transplantation

Paolo Fiorina, Franco Folli, Armando D'Angelo, Giovanna Finzi, Fabio Pellegatta, Valeria Guzzi, Carlo Fedeli, Patrizia Della Valle, Luciana Usellini, Claudia Placidi, Francesco Bifari, Daniela Belloni, Elisabetta Ferrero, Carlo Capella, Antonio Secchi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)2291-2300
Number of pages10
JournalDiabetes
Volume53
Issue number9
DOIs
Publication statusPublished - Sep 2004

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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    Fiorina, P., Folli, F., D'Angelo, A., Finzi, G., Pellegatta, F., Guzzi, V., Fedeli, C., Della Valle, P., Usellini, L., Placidi, C., Bifari, F., Belloni, D., Ferrero, E., Capella, C., & Secchi, A. (2004). Normalization of multiple hemostatic abnormalities in uremic type 1 diabetic patients after kidney-pancreas transplantation. Diabetes, 53(9), 2291-2300. https://doi.org/10.2337/diabetes.53.9.2291