Fibrinolysis in hypertensive patients with glomerulonephritis

Abstract

Background The role of fibrinolysis and serotonin in glomerulonephritis is still the matter of controversy. In essential hypertension fibrinolytic activity is diminished. The aim of the study was to assess some fibrinolytic parameters, in patients with glomerulonephritis in relation to healthy volunteers.
Material and methods Hypertensive patients with biopsyproven glomerulonephritis and normal renal function were treated for three months with nitrendipine (40 mg/day) (n = 18) or enalapril (20 mg/day) (n = 16). Healthy volunteers served as a control group. Activities of tPA and PAI-1 (amidolytic method), concentrations of tPA, PAI and tPA/PAI complexes (EIA) were studied by means of commercially available kits (Spectrolyse, Biopool, Sweden, Technoclone, Austria, respectively). Euglobulin clot lysis time (ECLT) was measured according to Kowarzyk and Buluk.
Results Diminished activity of tPA and a significant prolongation of ECLT was observed in hypertensive patients with glomerulonephritis when compared to healthy volunteers (p < 0.05). Concentration and activity of PAI were found to be higher in hypertensive patients when compared to the control group (p < 0.01). After 3 months of treatment with enalapril PAI concentration and activity decreased significantly, whereas in nitrendipine group a rise in tPA concentration was seen.
Conclusions Impairment in fibrinolysis in glomerulonephritis in hypertensive patients, may contribute to the increased risk of thromboembolic complications and accelerated atherosclerosis observed in these patients. Hypertensive treatment may favourably affect fibrinolysis in these patients.