Changes in Blood Coagulation and Fibrinolysis in the Nephrotic Syndrome

Abstract

In an attempt to elucidate the causes of the increased tendency to thrombosis in the nephrotic syndrome, changes in blood coagulation, fibrinolysis and biochemical function were measured in a group of patients with clinical and biochemical evidence of the nephrotic syndrome. These patients showed significant elevation of factor V, factor VIII, fibrinogen, plasminogen and α2-macroglobulin, while levels of antiplasmin activity and α1-antitrypsin were lowered. Fibrinogen, cholesterol, and antithrombin activity correlated significantly with each other as did levels of serum albumin, antiplasmin, and α1-antitrypsin. It appears that these changes take place passively as a result of increased protein synthesis and urinary loss of low molecular weight protein and not from primary changes in the coagulation or fibrinolytic mechanisms.