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Increased aggregation with normal surface charge and deformability of red blood cells in children with nephrotic
T Böhler1, O Linderkamp, A Leo
1Division of Neonatology, University Children's Hospital, Heidelberg, Germany.
Insights
In pediatric nephrotic syndrome (NS), increased red blood cell (RBC) aggregation and plasma viscosity are linked to higher thromboembolic risk. These hemorheological changes may explain the increased risk of blood clots in children with NS.
Area of Science:
- Pediatric Nephrology
- Hematology
- Thrombosis Research
Background:
- Idiopathic nephrotic syndrome (NS) in children is associated with an increased risk of thromboembolic events.
- Hemorheological factors, such as red blood cell (RBC) aggregation and plasma viscosity, are potential contributors to this risk.
Purpose of the Study:
- To evaluate hemorheological risk factors for thromboembolic disease in pediatric patients with idiopathic nephrotic syndrome (NS).
Main Methods:
- Assessed 25 pediatric patients with NS, comparing those with increased proteinuria to those in remission and healthy controls.
- Measured RBC aggregation, plasma viscosity, RBC surface charge, hematocrit, and RBC deformability.
- Correlated hemorheological parameters with clinical data, including proteinuria and plasma albumin levels.
Main Results:
- Patients with increased proteinuria exhibited significantly higher RBC aggregation and plasma viscosity compared to patients in remission and controls.
- RBC aggregation positively correlated with plasma viscosity, fibrinogen, alpha 2-macroglobulin, immunoglobulin M, and proteinuria degree.
- RBC aggregation negatively correlated with plasma albumin levels; RBC surface charge, hematocrit, and RBC deformability were similar across groups.
Conclusions:
- Increased RBC aggregation and plasma viscosity are significant hemorheological alterations in pediatric NS patients with active proteinuria.
- These altered hemorheological properties may contribute to the elevated risk of venous thromboembolism observed in NS.
Abstract:
Hemorheological risk factors for thromboembolic disease were evaluated in 25 pediatric patients with idiopathic nephrotic syndrome (NS). In patients with increased proteinuria (greater than 100 mg/m2/24 h) red blood cell (RBC) aggregation and plasma viscosity were significantly increased when compared with patients in remission (less than 100 mg/m2/24 h) and with healthy controls. RBC surface charge was normal during increased proteinuria and remission. RBC aggregation correlated positively with plasma viscosity, fibrinogen, alpha 2-macroglobulin, immunoglobulin M, and the degree of proteinuria, and negatively with plasma albumin levels. RBC aggregation showed no correlation to RBC surface charge. Hematocrit and RBC deformability (rheoscope) were similar in both patient groups and in controls. Increased RBC aggregation and plasma viscosity may contribute to the increased risk of venous thromboembolism in NS.