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Current Vascular Pharmacology

Editor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Hypercoagulability and Nephrotic Syndrome

Author(s): Antonietta Gigante, Biagio Barbano, Liborio Sardo, Paola Martina, Maria L. Gasperini, Raffaella Labbadia, Marta Liberatori, Antonio Amoroso and Rosario Cianci

Volume 12, Issue 3, 2014

Page: [512 - 517] Pages: 6

DOI: 10.2174/157016111203140518172048

Price: $65

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.

Keywords: Arterial thrombosis, deep venous thrombosis, nephrotic syndrome, proteinuria, renal venous thrombosis, venous thromboembolism.


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