Von Willebrand Factor, Dysfunction of the Vascular Endothelium, and the Development of Renal and Vascular Complications in Diabetes

This chapter will discuss the role of von Willebrand factor (vWF), a haemostatic glycoprotein synthesised by endothelial cells and megakaryocytes, and of dysfunction of the vascular endothelium in patients at very high risk of developing severe vascular complications.

Abstract

Both in IDDM [1–4] and in NIDDM [5–11], the presence of microalbuminuria or clinical proteinuria identifies a group of patients at very high risk of developing severe vascular complications, ie, proliferative retinopathy, renal insufficiency, and cardiovascular disease. Several hypotheses have been advanced to explain why an increased urinary albumin excretion rate should be associated with an excess of extrarenal complications [1,12–14]. This chapter will discuss the role of von Willebrand factor (vWF), a haemostatic glycoprotein synthesised by endothelial cells and megakaryocytes, and of dysfunction of the vascular endothelium.