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Prothrombotic factors in nephrotic syndrome
R Saxena1, V V Batra, N D Singh
1Department of Haematology, All India Institute of Medical Science, New Delhi.
Indian Journal of Pathology & Microbiology
|February 24, 2001
Summary
Nephrotic syndrome patients exhibit a hypercoagulable state, but clinical thrombosis is rare in Indians. This may be linked to elevated protein S levels, an anticoagulant factor, suggesting ethnic variations in thrombosis risk.
Area of Science:
- Nephrology
- Hematology
- Clinical Medicine
Background:
- Nephrotic syndrome is associated with a hypercoagulable state.
- The exact role of coagulation factors in nephrotic syndrome pathogenesis is debated.
- Limited data exists on Indian populations regarding this association.
Purpose of the Study:
- To investigate the clinical and laboratory profile of coagulation in Indian patients with nephrotic syndrome.
- To assess the prevalence of thrombosis and its relation to coagulation factors.
- To explore potential ethnic variations in thrombosis risk.
Main Methods:
- Studied 22 Indian nephrotic syndrome patients (age 18-35).
- Assessed coagulation profile: APTT, TT, PT, fibrinogen, Antithrombin III (ATIII), and Free Protein S levels.
- Evaluated platelet aggregation and used ultrasonography for deep vein thrombosis (DVT).
Main Results:
- Reduced ATIII levels (86.4%) and elevated Free Protein S levels (54.5%) were observed.
- Prolonged APTT (54.5%) and raised fibrinogen (22.7%) were noted.
- Only one patient (4.5%) had DVT, despite hypercoagulable markers; this patient had low ATIII.
Conclusions:
- Indian nephrotic syndrome patients demonstrate a hypercoagulable state.
- Clinical thrombosis is infrequent, potentially due to high Free Protein S levels.
- Ethnic factors may influence thrombosis risk in this population.