ISSN 2997-1036
International Journal of Hematology | Vol. 2, No. 4, April 2011 | pp. 25–32
DOI: 10.46882/2011/IJH/000016
Original Article
Title: Coagulation abnormalities and thrombotic risk factors in patients with nephrotic syndrome
Names of Authors: L. C. Okafor¹, A. T. Solarin², M. D. Alao³
Authors’ Affiliations: ¹Department of Haematology, Lagos State University Teaching Hospital, Ikeja, Nigeria; ²Department of Paediatrics and Nephrology, Lagos University Teaching Hospital, Idi-Araba, Nigeria; ³Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
Abstract: Nephrotic syndrome establishes a hypercoagulable state due to the urinary loss of low-molecular-weight anticoagulant proteins and concurrent hepatic synthesis of procoagulant factors. This study cross-sectionally evaluated 45 nephrotic patients and 45 healthy controls to quantify plasma levels of antithrombin III, fibrinogen, protein C, and D-dimer. Nephrotic individuals exhibited significantly lower mean antithrombin III levels (54.2 ± 11.6%) compared to controls (98.4 ± 10.2%, P < 0.001). Conversely, plasma fibrinogen concentrations were markedly elevated in the patient cohort (5.80 ± 1.20 g/L versus 2.90 ± 0.50 g/L in controls). Serum albumin levels correlated inversely with D-dimer concentrations (r = -0.62, P < 0.01), where patients with albumin below 20 g/L demonstrated the highest thrombotic risk indices. Deep vein thrombosis occurred in 3 patients (6.6%) during the study window. Routine profiling of antithrombin III and fibrinogen is valuable for identifying nephrotic patients at high risk for thromboembolic complications who may benefit from prophylactic anticoagulation.
Keywords: Nephrotic syndrome, hypercoagulability, antithrombin III, fibrinogen, thromboembolism
Manuscript Timeline: Received: January 10, 2011; Revised: February 18, 2011; Accepted: March 05, 2011; Published: April 12, 2011