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Hemostatic problems and thromboembolic complications in nephrotic children
1Departments of Pediatric Emergency and Pediatric Nephrology, Institute of Child Health, University of Istanbul, Istanbul, Turkey. citak@yildiz.edu.tr
Pediatric Nephrology (Berlin, Germany)
|February 23, 2000
Summary
Children with nephrotic syndrome (NS) face a high risk of blood clots. Low antithrombin III and albumin levels, along with high fibrinogen and cholesterol, contribute to this risk, which improves with corticosteroid treatment.
Area of Science:
- Pediatric Nephrology
- Hematology
- Thrombosis Research
Background:
- Nephrotic syndrome (NS) is associated with an increased risk of thromboembolism.
- Understanding coagulation abnormalities in pediatric NS is crucial for risk assessment and management.
Purpose of the Study:
- To evaluate coagulation status in children with NS before and after corticosteroid therapy.
- To compare coagulation parameters between children with NS and healthy controls.
Main Methods:
- Prospective study of 49 children with NS and 17 healthy controls.
- Assessment of clinical thromboembolism, coagulation factors (antithrombin III, protein C, protein S, fibrinogen), albumin, and cholesterol.
- Coagulation parameters were measured at disease onset and after corticosteroid treatment.
Main Results:
- Thromboembolism prevalence was 4% in pediatric NS patients, linked to low antithrombin III and high fibrinogen.
- Mean antithrombin III levels were significantly lower in NS patients (68.2%) compared to controls (84.0%), improving after corticosteroid therapy.
- Elevated plasma fibrinogen and cholesterol levels in NS patients normalized with remission; Protein C was higher, and Protein S was similar to controls.
Conclusions:
- Thromboembolic complications are common in pediatric nephrotic syndrome.
- Low antithrombin III and albumin, coupled with high fibrinogen and cholesterol, are key risk factors.
- Corticosteroid therapy may improve coagulation parameters in children with NS.