Title:Hypercoagulability and Nephrotic Syndrome
Volume: 12
Issue: 3
Author(s): Antonietta Gigante, Biagio Barbano, Liborio Sardo, Paola Martina, Maria L. Gasperini, Raffaella Labbadia, Marta Liberatori, Antonio Amoroso and Rosario Cianci
Affiliation:
Keywords:
Arterial thrombosis, deep venous thrombosis, nephrotic syndrome, proteinuria, renal venous thrombosis, venous
thromboembolism.
Abstract: 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.
