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[Activation of coagulation cascade in children during an idiopathic nephrotic syndrome relapse]
M Tkaczyk1, D Owczarek, B Puczko-Nogal
1Kliniki Nefrologii i Dializoterapii, z Pracowni Krzepniecia i Fibrynolizy Zakładu Diagnostyki Laboratoryjnej.
Insights
Children with relapsing idiopathic nephrotic syndrome (INS) show activated coagulation during the first 6 weeks of therapy. This indicates a prothrombotic state, even as metabolic issues resolve.
Area of Science:
- Pediatric Nephrology
- Hematology
- Clinical Biochemistry
Unlabelled:
The objective of this study was to assess concentrations of selected markers of coagulation in children with relapse of idiopathic nephrotic syndrome during a 6-week therapy. Study groups: 22 subjects (32 relapses)--14 males, 8 females (mean age 7.15 +/- 1.5 y.) with no thrombotic complications were included into the study. All children were clinically steroid-sensitive.
Methods:
Coagulation markers (platelet count, thrombin time, APTT, INR, fibrinogen 1 + 2 fragments (F1 + 2), thrombin-antithrombin complexes (TAT), serum levels of D-dimer (DD), fibrin monomers (FM) and antithrombin activity (ATIII)) were measured three times: on admission, after 2 and 6 weeks. The control group consisted of 13 healthy children.
Results:
Serum concentration of TAT or F1 + 2 did not differ between 3 stages (p > 0.05). However, values at 0 and 2 weeks were significantly higher than in control group (p < 0.05). We found no correlation between TAT or F1 + 2 and FBG, ALB, TCH, TG levels. [table: see text]
Conclusions:
The coagulation cascade in relapse of NS was activated during first 6 weeks of therapy whereas metabolic disturbances (low ALB, high FGB, TCH, TG, high platelets) normalized. It is speculative whether it was caused by active immunological process but definitely it resulted in "prothrombotic state" in INS patients.