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A Hypercoagulable State

Alan G. Kendall, MD; Reinhard C. Lohmann, MD; John B. Dossetor, MD

Arch Intern Med. 1971;127(6):1021-1027.

Abstract
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.

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.

Footnotes
Received for publication Dec 19, 1969; accepted Dec 30, 1970.

Reprint requests to Department of Medicine, University of Alberta, Edmonton 61, Alberta, Canada (Dr. Dossetor).

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