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[Haemostasis in nephrotic syndrome]
1Klinika Pediatrii, CMKP, Czerniakowska, 00-416 Warszawa, Poland.
Disturbances in haemostasis and rheology in the nephrotic syndrome frequently lead to coagulopathy. In spite of numerous studies the pathogenesis of that phenomenon remains not convincingly explained. A cause of more frequent incidence of evident thromboembolic events in adults (about 30%) as compared with children (about 3%) is not clear either. The type of glomeluropathy and the presence of atherosclerosis seem to be essential. Present opinions concerning the role of individual haemostasis components and other factors effecting the raise of thrombotic dispositions are shown in our study. Real effect of these disturbances on the incidence of thromboembolic complications in the course of glomeluropathy evokes many controversies. Majority of them present as a microthrombosis, with little or no symptoms, and markedly outnumbers evident events. They can be diagnosed by means of invasive and costly methods. Simple to perform and cheaper diagnostic methods are looked for. Global tests assessing the haemostasis are useless in these conditions. The number of so called "intravascular haemostasis activation markers" is high, but none of them are objective.
Disturbances in haemostasis and rheology in the nephrotic syndrome frequently lead to coagulopathy. In spite of numerous studies the pathogenesis of that phenomenon remains not convincingly explained. A cause of more frequent incidence of evident thromboembolic events in adults (about 30%) as compared with children (about 3%) is not clear either. The type of glomeluropathy and the presence of atherosclerosis seem to be essential. Present opinions concerning the role of individual haemostasis components and other factors effecting the raise of thrombotic dispositions are shown in our study. Real effect of these disturbances on the incidence of thromboembolic complications in the course of glomeluropathy evokes many controversies. Majority of them present as a microthrombosis, with little or no symptoms, and markedly outnumbers evident events. They can be diagnosed by means of invasive and costly methods. Simple to perform and cheaper diagnostic methods are looked for. Global tests assessing the haemostasis are useless in these conditions. The number of so called "intravascular haemostasis activation markers" is high, but none of them are objective.