Hyperleptinemia is also common in chronic renal failure, particularly in CAPD. On the other hand, cardiovascular events related to thrombosis are a predominant cause of death and account also for an important morbidity in uremic patients. Treatment with recombinant human erythropoietin (rHuEPO) may shift the precarious hemostatic balance towards thrombosis. Therefore, the aim of the study was to assess the relationships between leptin and platelet aggregation and some hemostatic parameters in CAPD patients treated with rHuEPO. The study was performed on 15 patients maintained on CAPD given rHuEPO and 13 subjects without rHuEPO therapy served as a control group. Platelet aggregation was studied in both platelet-rich plasma (PRP) and in the whole blood. Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) (antigens and activities), von Willebrand factor, trombomodulin, protein C, thrombin activatable fibrinolysis inhibitor (TAFI) and leptin (serum and dialysate) were assayed by using commercially available kits. Patients in both groups studied did not differ significantly with respect to age, BMI, duration of renal replacement therapy, and other hematological and hemostatic parameters studied as well as leptin serum and dialysate leptin. In CAPD patients treated with rHuEPO serum and dialysate leptin significantly correlated with tissue factor pathway inhibitor, protein C, thrombomodulin, ristocetin-induced platelet aggregation in the whole blood and PRP. In CAPD patients not treated with rHuEPO the significant correlations were observed between serum and dialysate leptin and protein C. Positive correlations between platelet aggregation and leptinemia in CAPD patients might indicate that hyperleptinemia could be associated with the cardiovascular disease in dialyzed patients. Leptin might contribute at least in part to the thrombotic complications observed in CAPD patients.

Zhang Y, Proenca R, Maffei M, Barone M, Lori L, Friedman JM: Positional cloning of the mouse ob gene and its human homologue. Nature 1994;372:425–432.
Cioffi JA, Shafer AW, Zupancic TJ, Smith-Gbur J, Mikhail A, Platika D, Snodgrass HR: Novel B219/OB receptor isoforms: possible role of leptin in hematopoiesis and reproduction. Nature Med 1996;2:585–589.
Konstantinides S, Schaefer K, Loskutoff DJ: Leptin modulates platelet function and enhances arterial thrombosis in vivo. Thromb Haemost 2001, suppl OC.
Heimburger O, Lonnqvist F, Danielsson A, Nordenstrom J, Stenvinkel P: Serum immunoreactive leptin concentrations and its relation to the body fat content in chronic renal failure. J Am Soc Nephrol 1997;8:1423–1430.
Dagogo-Jack S, Ovalle F, Geary B, Landt M, Coyne DW: Hyperleptinemia in patients with end-stage renal disease treated by peritoneal dialysis. Perit Dial Int 1998;18:34–40.
Sharma K, Considine RV, Michael B, Dunn SR, Wiesberg LS, Kurnik PB, Kurnik BRC, O’Connor J, Sinha M, Caro JF: Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients. Kidney Int 1997;41:1980–1985.
Kawaguchi Y, Kubo H, Yamamoto H, Nakayama K, Shigematsu T, Sakai O: Is atherosclerosis accelerated by CAPD? Perit Dial Int 1996;16(suppl 1):S23–S30.
Malyszko J, Urano T, Knofler R, Taminato A, Yoshimi T, Takada Y, Takada A: Daily variations of platelet aggregation in relation to blood and plasma serotonin in diabetes. Thromb Res 1994;75:569–576.
Wilsoncroft PS, Lofts FJ, Griffits RJ, Moore PK: The effect of 6-oxo-PGE1 on human platelet aggregation in whole blood in vitro. J Pharm Pharmacol 1995;37:139–141.
Malyszko J, Malyszko JS, Mysliwiec M, Takada Y, Takada A: Cyclosporine and FK 506 affect platelet function in vitro. Platelets 1995;6:366–370.
Born GVR: Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature 1962;194:927–929.
Małyszko J, Małyszko JS, Mysliwiec M: Comparison of hemostasis between CAPD and HD patients. Perit Dial Int 2001;21:158–165.
Kowalski E, Kopec M, Niewiarowski S: An evaluation of the euglobulin method for determination of fibrinolysis. J Clin Pathol 1959;12:215–221.
Stenvinkel P: Leptin – A new hormone of definite interest for the nephrologist. Nephrol Dial Transplant 1998:13:1099–1101.
Małyszko J, Zbroch E, Wołczyński S, Małyszko JS, Hryszko T, Myśliwiec M: Leptin and serum erythropoietin in hemodialyzed and peritoneally dialyzed uremic patients during rHuEPO therapy. Am J Nephrol 2000;20:180–188.
Nordfors L, Lonnqvist F, Heimburger O, Danielsson A, Schalling M, Stenvinkel P: Low leptin gene expression and hyperleptinemia in chronic renal failure. Kidney Int 1998;54:1267–1275.
Maruyama I, Nakata M, Yamaji K: Effect of leptin in platelet and endothelial cells. Obesity and arterial thrombosis. Ann N Y Acad Sci 2000;902:315–319.
Nakata M, Yada T, Soejima N, Maruyama I: Leptin promotes aggregation of human platelets via the long form of its receptor. Diabetes 1999;48:426–429.
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