Platelet abnormalities in nephrotic syndrome.
Nephrotic syndrome (NS) is a common kidney disease associated with a significantly increased risk of thrombotic events. Alterations in plasma levels of pro- and anti-coagulant factors are involved in the pathophysiology of venous thrombosis in NS. However, the fact that the risk of both venous and arterial thrombosis is elevated in NS points to an additional role for blood platelets. Increased platelet counts and platelet hyperactivity have been observed in nephrotic children. Platelet hyperaggregability, increased release of active substances, and elevated surface expression of activation-dependent platelet markers have been documented. The mechanisms underlying those platelet alterations are multifactorial and are probably due to changes in plasma levels of platelet-interfering proteins and lipid changes, as a consequence of nephrosis. The causal relationship between platelet alterations seen in NS and the occurrence of thromboembolic phenomena remains unclear. Moreover, the efficiency of prophylactic treatment using antiplatelet agents for the prevention of thrombotic complications in nephrotic patients is also unknown. Thus, antiplatelet medication is currently not generally recommended for routine prophylactic therapy.
Pediatric Nephrology, Department of Pediatrics, University hospital of Leuven, Leuven, Belgium. benedicte.eneman@uzleuven.be.|Laboratory of Pediatric Nephrology, Department of Development & Regeneration, KU Leuven, Leuven, Belgium. benedicte.eneman@uzleuven.be.
Benedicte
B
Eneman
Pediatric Nephrology, Department of Pediatrics, University hospital of Leuven, Leuven, Belgium.|Laboratory of Pediatric Nephrology, Department of Development & Regeneration, KU Leuven, Leuven, Belgium.
Elena
E
Levtchenko
Laboratory of Pediatric Nephrology, Department of Development & Regeneration, KU Leuven, Leuven, Belgium.
Bert
B
van den Heuvel
Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium.
Chris
C
Van Geet
Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium.
Kathleen
K
Freson
D001792:Blood Platelets / Q000473:pathology*; D002648:Child; D006801:Humans; D009404:Nephrotic Syndrome / Q000097:blood* / Q000503:physiopathology
Antiplatelet therapy; Nephrotic syndrome; Platelet hyperaggregability; Thrombocytosis; Thrombosis