Intraperitoneal hypercoagulation and hypofibrinolysis is present in childhood peritonitis

An increased rate of obstruction of peritoneal dialysis catheters is observ ed during peritonitis. Hypercoagulation and hypofibrinolysis may explain th is increased occurrence. We studied plasminogen activator inhibitor type 1 antigen (PAI-1), tissue-type plasminogen activator antigen (t-PA), D-dimer (DD), plasmin-alpha(2)-antiplasmin complexes (PAP), and thrombin-antithromb in III complexes (TAT) in 7 children with peritonitis (group A) and 12 chil dren during stable peritoneal dialysis (group B). Albumin, beta(2)-microglo bulin, IgG, and alpha(2)-macroglobulin were measured for baseline transperi toneal protein transport. After a dwell of 6 h with 1.36% Dianeal, dialysat e and serum samples were collected. Dialysate to plasma ratios of all prote ins were calculated. During peritonitis (group A) TAT was higher: 34.7 vers us 22.0 (P=0.01). PAI-1 was increased in group A: 76.5 versus 22.9 (P=0.004 ). PAP was decreased during peritonitis (group A): 24.9 versus 39.3 (P=0.01 ). In group A, DD were decreased. 10.8 versus 26.7 (P=0.002), t-PA was simi lar in both groups (23.7 in group A vs. 27.7 in group B; P=0.26). In both g roups TAT, PAI-1, t-PA, PAP, and DD were significantly higher than in basel ine transperitoneal transport, suggesting intraperitoneal production. Hyper coagulability and hypofibrinolysis were present during peritonitis compared with the control situation.