ISSN 2997-1036
International Journal of Hematology | Vol. 10, No. 8, August 2019 | pp. 57–64
DOI: 10.46882/2019/IJH/000116
Original Article
Title: Evaluation of baseline plasma protein C functional activity variations as an independent predictor of recurrent macrovascular thrombosis in nephrotic syndrome
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: Excessive renal loss of anticoagulant regulatory elements establishes a profound hypercoagulable state in nephrotic disease, but the predictive utility of functional protein C monitoring remains under-analyzed. This prospective study evaluated baseline plasma free protein C functional activity in 54 adult patients with active nephrotic syndrome to track correlations with serum albumin depletion and 1-year thrombotic recurrence outcomes. Protein C activity was quantified via chromogenic substrate assays prior to initiating standard immunosuppressive therapy. Severe protein C activity reduction (< 55.0%) was identified in 29.6% (16 of 54) of the nephrotic patients. Multivariable Cox proportional hazards analysis revealed that baseline protein C functional activity below 55.0% was an independent predictor of acute deep vein thrombosis or pulmonary embolism within a 12-month observation window (hazard ratio = 3.84, P < 0.01). Protein C depression correlated inversely with serum albumin levels (r = -0.65, P < 0.001) and positively with D-dimer concentrations. Screening for functional protein C profiles provides clear prognostic utility, helping identify high-risk nephrotic populations requiring early prophylactic anticoagulation.
Keywords: Nephrotic syndrome, protein C activity, hypercoagulability, albuminuria, thromboembolism
Manuscript Timeline: Received: May 12, 2019; Revised: June 20, 2019; Accepted: July 10, 2019; Published: August 17, 2019