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[Thromboembolic complications in nephrotic syndrome]
L A Bobrova1, N L Kozlovskaya2,3
1Sechenov First Moscow State Medical University (Sechenov University).
Terapevticheskii Arkhiv
|December 21, 2020
Summary
Nephrotic syndrome (NS) increases thrombotic risk due to imbalanced clotting factors and protein loss. New research highlights endothelial microparticles in generalized thrombosis development, posing challenges for anticoagulant therapy decisions.
Area of Science:
- Nephrology
- Hematology
- Pathophysiology
Background:
- Nephrotic syndrome (NS) is associated with a high risk of thrombotic events.
- Understanding the complex mechanisms of hypercoagulation in NS is crucial for patient management.
Purpose of the Study:
- To review the pathogenesis of thrombotic outcomes in nephrotic syndrome.
- To discuss the imbalance of procoagulant and anticoagulant mechanisms.
- To present new findings on thrombogenesis in NS.
Main Methods:
- Literature review focusing on hypercoagulation disorders in NS.
- Analysis of procoagulant and anticoagulant mechanisms.
- Examination of the role of endothelial microparticles.
Main Results:
- Imbalanced coagulation is driven by urinary loss of anticoagulants, impaired fibrinolysis, increased clotting factors, and platelet activation.
- Endothelial microparticles from damaged glomeruli contribute to generalized thrombosis.
- Common arterial and venous thromboses, risk factors, and patient-specific variations are detailed.
Conclusions:
- The decision regarding the timing and method of anticoagulant therapy in NS patients remains a significant clinical challenge.
- Further research is needed to optimize thromboprophylaxis and treatment strategies.
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