On Fibrinolytic Split Products in Serum and Urine in Uraemia

Abstract

Serum (in 84 cases) and urine (in 33 cases) from patients with acute and chronic uraemia were examined immunoelectrophoretically for fibrinolytic split products (FSP). FSP in serum were found in 9 out of 12 acute cases, in 12 out of 40 conservatively treated chronic cases, and in 13 out of 32 chronic cases, on maintenance haemodialysis. Also in urine FSP tended to be more common in acute than in chronic cases. In conservatively treated chronic cases the occurrence of FSP varied with the clinical activity of the disease and the degree of uraemia.

There were no definite signs of systemic fibrinolysis or disseminated intravascular coagulation in cases with FSP, so that the split products must derive from dissolution of local fibrin deposits. The demonstration of high molecular weight FSP both in serum and urine or only in the urine and in the absence of post-renal disease strongly suggests the presence of such local fibrin deposits in the kidney.

Examination of serum and urine for FSP may be useful in the investigation of renal disease and may also facilitate selection of those cases where treatment with anticoagulants is indicated as well as evaluation of the effect of therapy and the course of the disease.