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June 1971

Nephrotic Syndrome: A Hypercoagulable State

Author Affiliations

Montreal; Edmonton, Alberta, Canada

From the division of Hematology, Royal Victoria Hospital, Montreal (Drs. Kendall and Lohmann) and the Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada.

Arch Intern Med. 1971;127(6):1021-1027. doi:10.1001/archinte.1971.00310180037003

Coagulation tests were performed before and after institution of conventional therapy, and after clinical remissions, in 35 nonazotemic patients with nephrotic syndrome. Pretreatment studies revealed elevated levels of plasma fibrinogen, factors V, combined VII and X, and VIII, mild thrombocytosis, and accelerated thromboplastin generation. Several thromboembolic complications occurred in these patients and anticoagulant therapy was given to two of them. The abnormal results of tests tended to normalize with clinical remission. It is concluded that the nephrotic syndrome is often associated with blood hypercoagulability and a risk of thromboembolism, and that this may be enhanced by corticosteroid therapy. When renal vein thrombosis occurs it is probably another manifestation of the hypercoagulable state more often than a de novo cause of nephrotic syndrome. Long-term anticoagulant therapy may have a place in the management of nephrotic patients.