Hypercoagulability and nephrotic syndrome.
Patients with nephrotic syndrome are at increased risk for thromboembolic events such as deep venous and arterial thrombosis, renal vein thrombosis and pulmonary embolism. This thrombophilic phenomenon has been attributed to a "hypercoagulable" state in which an imbalance between naturally occurring pro-coagulant/pro-thrombotic factors and anti-coagulant/antithrombotic factors promotes in situ thrombosis in deep veins or arteries. Management of thromboembolic events may be divided in prophylactic and therapeutic strategies. Hypoalbuminemia is the most significant independent predictor factor of thrombotic risk, especially for values <2 g/dL. However, the most important question in these patients is whether to anticoagulate prophylactically or not. The decision depends on type of glomerulonephritis, proteinuria severity, other predisposing factors and prior history of thrombosis. Reviewing the recent literature, we suggest the best therapeutic management of anticoagulation for patients with nephrotic syndrome, focusing on prophylactic strategies.
Antonietta
A
Gigante
Biagio
B
Barbano
Liborio
L
Sardo
Paola
P
Martina
Maria L
ML
Gasperini
Raffaella
R
Labbadia
Marta
M
Liberatori
Antonio
A
Amoroso
Department of Nephrology, "Sapienza" University of Rome, Viale del Policlinico 155, Rome, Italy. biagionet@hotmail.com.
Rosario
R
Cianci
D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D006801:Humans; D009404:Nephrotic Syndrome / Q000097:blood / Q000150:complications*; D019851:Thrombophilia / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D013927:Thrombosis / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants