A comprehensive study of haemostasis has been performed in a homogeneous group of 20 patients with nephrotic syndrome without renal failure. We have found unchanged number of platelets and a significant increase of platelet adhesiveness and aggregation; increased levels of activity and related antigen of fibrinogen, of factor VIII, of activity of factors II, VII and X and of antigens of factors XIII. Antithrombin III was unchanged in plasma and was detected in the urine. Euglobulin lysis times were decreased, and levels of plasminogen and its activators were increased after a venous occlusion test. At the same time urokinase inhibitors and antiplasmins were increased not only after, but also before a venous occlusion test. Fibrinogen degradation products have been found in the urine of all our patients but not in their sera.

A comprehensive study of haemostasis has been performed in a homogeneous group of 25 adult patients with conservatively treated chronic uraemia. We have found prolonged bleeding time, impaired platelet adhesiveness and aggregation, and decreased platelet factor 3 activity, increased values of fibrinogen, of factor VIII activity and related antigen, and of combined levels of factors II, VII and X. Non-significantly abnormal concentrations of factor XIII and of plasminogen and significantly lower values of plasminogen activators and higher values of urokinase inhibitors and anti-plasmin have also been found. Fibrinogen degradation products were detected in the urine of some patients.

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Fibrinopeptide A (FPA), a sensitive index of in vivo thrombin activity, β-thromboglobulin (βTG) and platelet factor 4 (PF4), specific markers of platelet intravascular activation, have been measured in plasma by radioimmunoassays in 23 patients with nephrotic syndrome and in 32 normal subjects. FPA concentration was 2.40 ± 1.42 ng/ml (mean ± SD) in nephrotic patients and 1.16 ± 0.58 ng/ml in normal controls (p < 0.001); βTG concentration was 57.9 ± 33.2 ng/ml in nephrotic patients and 25.7 ± 7.4 ng/ml in controls (p < 0.001); PF4 level was not different from controls. These data indicate in vivo blood hypercoagulability and platelet hyperfunction in nephrotic syndrome. Moreover, we have documented a slow in vitro FPA generation pattern (ΔFPA): 0.97 ± 0.51 ng/ml/l0 min; this suggests that thrombin activity is predominantly local.

Antithrombin III (At-III) activity and protein, heparin cofactor activity, anti-factor Xa activity were determined in 200 healthy adults, evenly distributed within age and sex groups, in 60 patients with cerebral thrombosis and in 20 oral contraceptive users. There was a positive correlation between At-III protein and its activities in normal subjects and in patients with cerebral thrombosis, The mean At-III protein and heparin cofactor activity values decreased with age in men and in women of fertile age. The mean values of At-III protein and its activities did not show any variation in the patients with cerebral thrombosis when compared with the normals. In oral contraceptive users a positive correlation was also found between At-III protein and its activities, antifactor Xa activity excepted. The mean antifactor Xa activity value in these women decreased during treatment, whereas the other At-III activities and At-III protein were unchanged.