Abstract: 【Abstract】Objective To investigate the pathogenesis of endothelial cell injury and coagulation disorder in hemodialysis patients with different primary diseases. Methods Enzyme linked immunosorbent assay was used to measure the plasma soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willebrand factor (vWF) and tissue factor (TF) in maintenance hemodialysis patients (MHD group, n=42) and healthy volunteers (control group, n=22).  Results (a) The levels of sVCAM-1, vWF and TF were significantly higher in MHD group than in control group (t=-7.809, -6.559 and -16.821, respectively; P =0.005, 0.004 and 0.000, respectively). The levels of sVCAM-1, vWF and TF were significantly higher in MHD patients with type II diabetes (2-DM) than those without diabetes (t=-20.605, 12.792 and 8.600, respectively; P=0.046, 0.032 and 0.047, respectively); (b) Logistic regression analysis showed that sVCAM-1, vWF and TF levels correlated to the presence of 2-DM. (c) vWF level after a hemodialysis session increased significantly as compared to the level before the hemodialysis session (t=-5.943, P = 0.000). TF level increased after a hemodialysis session but without statistical significance (t=-3.558, P =0.205). The differences of vWF and TF levels before and after hemodialysis sessions were insignificant between MHD patients with 2-DM and those without diabetes (t=-3.058, -2.241, -5.931, and -8.439, respectively; P =0.070, 0.302, 0.085, and 0.155, respectively). The difference of vWF level before and after hemodialysis sessions correlated positively with hemodialysis age (r=0.328, P＜0.05).  Conclusion Endothelial cell injury and hypercoagulation state exist in MHD patients with 2-MD as well as in those with other primary diseases. These changes aggravate after hemodialysis especially in those with longer hemodialysis age.

Key words: Diabetes mellitus, Hemodialysis, Endothelium, Soluble vascular cell adhesion molecule-1, von Willebrand factor, Tissue factor