Blood Coagulation and the Nephrotic Syndrome: Deficiency or Excess?

Duarte, R.; Mughal, Tariq I.; Al-Rogi, Abdullah

doi:10.5144/0256-4947.1990.187

Cited by 2 publications

(4 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no significant difference in platelet counts of children in relapse, compared with those of children in remission or with controls.However, thrombocytosis was observed in 57% of subjects with onset. Platelets are known to play a crucial role in the pathogenesis of thrombotic changes in NS [ 3 , 31 , 34 ]. Although the exact mechanism of elevated platelet count in nephrotic syndrome is unknown, it is assumed that biochemical disorders associated with hypoalbuminaemia lead to increased platelet aggregation and are responsible for the elevated platelet counts [ 3 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Platelets are known to play a crucial role in the pathogenesis of thrombotic changes in NS [ 3 , 31 , 34 ]. Although the exact mechanism of elevated platelet count in nephrotic syndrome is unknown, it is assumed that biochemical disorders associated with hypoalbuminaemia lead to increased platelet aggregation and are responsible for the elevated platelet counts [ 3 , 34 ]. Hypoalbuminaemia correlates negatively with platelet count, as such platelet counts are expected to return to normal as the patient goes into remission [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The authors postulated that the shortened APTT seen in relapse may be due to an increase in hepatic synthesis of pro-coagulants in response to urinary losses of albumin and antithrombin [29]. Although studies have shown that the interplay of pro-coagulant and anticoagulant factors ultimately describe the coagulation derangements seen in nephrotic syndrome [21,29,[31][32][33] the rate and synthesis of these factors are not clearly elucidated [33,34]. Patients with nephrotic syndrome tend to suffer from a spectrum of haemostatic disorders, ranging from an increased incidence of thromboembolism to an increased bleeding tendency [34,35].…”

Section: Discussionmentioning

confidence: 99%

“…Although studies have shown that the interplay of pro-coagulant and anticoagulant factors ultimately describe the coagulation derangements seen in nephrotic syndrome [21,29,[31][32][33] the rate and synthesis of these factors are not clearly elucidated [33,34]. Patients with nephrotic syndrome tend to suffer from a spectrum of haemostatic disorders, ranging from an increased incidence of thromboembolism to an increased bleeding tendency [34,35]. The median prothrombin time in subjects and controls was 12 s and 13 s respectively.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Haemostatic profile of children with nephrotic syndrome attending University of Nigeria Teaching Hospital Ituku-Ozalla, Nigeria

et al. 2022

View full text Add to dashboard Cite

Background Haemostatic derangements are thought to be due to an imbalance between hepatic synthesis of pro-coagulants and urinary losses of anticoagulants. Objectives This study evaluated the coagulation profile of Nigerian children with nephrotic syndrome and examined the relationship between coagulation variables, disease state and steroid responsiveness. Methods A cross- sectional hospital based study on evaluation of coagulation profile of children with nephrotic syndrome compared with their age- and gender- matched controls. Results The median fibrinogen level in subjects and controls was the same (2.9 g/L). Sixteen of 46 (35%) children with nephrotic syndrome had hyperfibrinogenaemia. The median fibrinogen level of children in remission was 2.3 g/L and differed significantly when compared with those of children in relapse (p = 0.001). The median APTT of children with nephrotic syndrome was 45.0 s and differed significantly compared with those of controls (42.0 s) (p value = 0.02). The median prothrombin time in children with and without nephrotic syndrome were 12.0 and 13.0 s respectively, (p = 0.004). About 90% of children with nephrotic syndrome had INR within reference range. Thrombocytosis was found in 15% of children with nephrotic syndrome. The median platelet count in children with new disease was 432 × 103cells/mm3 and differed significantly when compared with those of controls (p = 0.01). INR was significantly shorter in children with steroid resistant nephrotic syndrome (SRNS) (median 0.8 s; IQR 0.8 -0.9 s) compared with controls (median 1.0 s; IQR 1.0 -1.1 s) (p = 0.01). Steroid sensitivity was the strongest predictor of remission in children with nephrotic syndrome; steroid sensitive patients were 30 times more likely to be in remission than in relapse (OR 30.03; CI 2.01 – 448.04). Conclusion This study shows that the haemostatic derangements in childhood nephrotic involve mostly fibrinogen, APTT, PT, INR and platelet counts. Antithrombin levels are largely unaffected. Variations in fibrinogen, APTT, PT and INR values may be due to the heterogeneous nature of the disease.

show abstract