ISSN 2997-1036
International Journal of Hematology | Vol. 11, No. 6, June 2020 | pp. 41–48
DOI: 10.46882/2020/IJH/000126
Original Article
Title: Evaluation of baseline plasma protein C functional activity as an independent predictor of thromboembolic recurrence in active 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: Massive renal wasting of natural anticoagulant factors establishes a profound hypercoagulable state in nephrotic disease, yet the clinical utility of functional protein C monitoring remains under-studied. This prospective study evaluated baseline plasma free protein C functional activity in 54 adult patients with active nephrotic syndrome to track its correlation with serum albumin depletion and 1-year thromboembolic recurrence outcomes. Protein C activity was quantified via chromogenic substrate assays prior to initiating 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 follow-up 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: March 14, 2020; Revised: April 25, 2020; Accepted: May 12, 2020; Published: June 19, 2020