Clinical correlation between hypercoagulability and thrombo-embolic phenomena

Robert, A.; Olmer, M; Sampol, J; Gugliotta, J.; Casanova, Paul

doi:10.1038/ki.1987.73

Cited by 65 publications

(50 citation statements)

References 14 publications

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“…Venous thrombosis, which includes renal vein thrombosis (which is frequently seen in the patients with membranous glomerulonephritis), pulmonary embolism and deep vein thrombosis are common [13]. The incidence of such complications in the minimal change nephrotic syndrome is low.…”

Section: Discussionmentioning

confidence: 99%

“…Still, low serum albumin levels (<25g/l), high rates of protein excretion (>10g/24hours), high fibrinogen levels, low AT III levels (< 75%), and hypovolaemia are associated with an excessive risk of the thromboembolic complications [13].…”

Section: Discussionmentioning

confidence: 99%

“…This increased aggregability has been attributed to hypoalbuminaemia, because albumin inhibits the AA-induced platelet aggregation and the conversion of the AA which is released from the platelet phospholipids to endoperoxide intermediates and TXA2. The additional mechanisms which are involved may include hypocalcaemia and hypercholesteraemia (which are commonly seen in the nephrotic syndrome) [13].…”

Section: Discussionmentioning

confidence: 99%

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Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome

Mittal

Aggarwal²,

Saluja³

et al. 2013

JCDR

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Introduction: Only little is known on the effect of the platelet function in the paediatric nephrotic syndrome. The earlier studies which had been done on hypercoagulability have mainly featured the secondary forms of the nephrotic syndrome and the data on the minimal change type of disease is limited.We therefore, made an effort to study the platelet functions and the coagulation profile in children with the nephrotic syndrome,to find the relationship between the steroid response and the coagulation profile, and to look for the correlation between thromboembolism and the hypercoagulable states.Methodology: Twenty nine children with the steroid responsive nephrotic syndromewere studied to see the platelet aggregation and the coagulation parameters and their response to the steroid therapy. Doppler studies were done for the renal vein and the inferior vena cava (IVC) thrombus.Results: It was seen that an increased aggregability of the platelets occurred with Adenosine diphosphate (ADP) and collagen (out of the four agonists, ADP, Collagen, Ristocetin and Arachidonic acid) which were used as agonists for the assay.We also observed that the Partial thromboplastin time (PTT) had become prolonged and a significant decline in the high values of the procoagulant proteins (Protein C and Protein S) was seen after the steroid therapy and when the children went into remission. These findings were suggestive of a reversibility of the changes in the steroid responsive nephrotic syndrome with the steroid therapy.One child was found to have thrombosis of the inferior vena cava (IVC) on Doppler studies, which resolved with treatment subsequently.Conclusions: An increased platelet aggregability contributes to the hypercoagulable states, that may increase the incidence of thrombosis in such patients. Although the incidence of such complications is very low, in a given child with the hypercoagulable states, Doppler may be used to look for any evidence of a latent thrombus and, an early intervention could be instituted. A change in the coagulation parameters points to the reversibility of the changes which are produced in a diseased state.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome

Mittal

Aggarwal²,

Saluja³

et al. 2013

JCDR

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show abstract

“…9 Patients with membranous glomerulopathy and heavy proteinuria run the highest risk. 5,6,8 The pathophysiological mechanisms of thromboembolism in patients with nephrotic syndrome include, alterations in plasma levels of proteins involved in coagulation and fibrinolysis, enhanced platelet aggregation, low plasma albumin, hyper-viscosity and hyperlipidemia, as well as treatment with corticosteroids and diuretics. 10 There are no clear factors indicating relationship of PT, APTT and fibrinogen to protein/creatinine ratio in nephrotic syndrome children.…”

Section: Introductionmentioning

confidence: 99%

A study of PT, APTT, fibrinogen and urinary protein-creatinine ratio in paediatric patients with nephrotic syndrome

Rani

2014

Int J Contemp Pediatr

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“…[1][2][3] Although the association between nephrotic syndrome and thromboembolic complications has been recognized for more than a century, the precise causal relationship is not entirely understood. [4][5][6] Moreover, the association between the increased bleeding tendency and nephrotic syndrome is also somewhat unclear.…”

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confidence: 99%