[Molecular markers of hemostasis activation in children with nephrotic syndrome]

Vein and arterial thrombosis is a rather rare but potentially life-threatening complication of nephrotic syndrome (n.s.). None of the specific markers of hypercoagulability state in n.s. have been identified. The aim of the study was to estimate plasma parameters of prothrombic state in children with n.s. Ten children aged from 3 to 10 yrs (mean 5.7 +/- 2.5) with recurrence of n.s. and 10 healthy controls matched for age and sex were studied. In all children with n.s. prothrombin fragments F 1+2, D-dimers (D-d), thrombin-antithrombin III complexes (TAT) and whole blood clotting time thrombin time, prothrombin time, plasma fibrinogen and platelet count were determined in the hypovolemic state (before therapy was started), in the normovolemic state (after plasma expander was used) and in the course of anticoagulation treatment (two week dicumarol therapy). In comparison with healthy controls all children with recurrence of n.s. in the hypovolemic state showed a significant (p < 0.05) increase of D-d (910 vs 500 ng/ml), TAT (14.26 vs 2.6 ng/ml), F 1+2 (5.68 vs 0.79 nmol/l), plasma fibrinogen (592 vs 272 mg/dl), platelet count (632 vs 275 x 10(9)/l) and shortening of WBCT (30.0 vs 35 s). Plasma volume expansion produced by dekstran was followed by a moderate decrease of all parameters. Two-week anticoagulant treatment had no impact on estimated haemostasis parameters.