Comprehensive coagulation and fibrinolytic potential in the acute phase of pediatric patients with idiopathic nephrotic syndrome evaluated by whole blood-based ... View Full Text


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Article Info

DATE

2022-01-08

AUTHORS

Tomoaki Ishikawa, Yuto Nakajima, Takashi Omae, Kenichi Ogiwara, Keiji Nogami

ABSTRACT

BackgroundVenous thromboembolism is a rare, serious complication of idiopathic nephrotic syndrome (INS) in childhood. The mechanisms responsible for the hypercoagulable state in the acute phase of INS are poorly understood, however. This study aimed to assess overall coagulation and fibrinolytic function in pediatric patients with INS.MethodsGlobal coagulation and fibrinolysis were examined in whole blood samples from 22 children with initial onset INS (initial-group), 22 children with relapsed INS (relapse-group), and 15 control pediatric patients using rotational thromboelastometry (ROTEM®). In the initial-group, blood samples were obtained before (week 0) and 1–4 weeks after initiation of corticosteroid therapy. EXTEM and FIBTEM were used to assess coagulation and fibrinolysis, respectively. Clot time (CT), clot formation time (CFT), maximum clot firmness (MCF), and α-angle were determined as coagulation parameters, and lysis index at 30 and 60 min (LI30 and LI60, respectively) were assessed as fibrinolytic parameters.ResultsCT was significantly shortened, and MCF and α-angle were significantly greater than controls at week 0 and week 1 both in the initial-group and the relapse-group. MCF correlated with serum albumin (r = 0.70, p < 0.001) and fibrinogen level (r = 0.68, p < 0.001). The fibrinolytic parameters (LI30 and LI60) in the initial-group were stable and higher than those in controls at all time points (p < 0.01).ConclusionsWe have shown that the hypofibrinolytic defect did not improve with effective NS treatment at the early 4-week time-point. Additionally, a likely pre-thrombotic state was evident in the period before initial onset and 1 week after corticosteroid therapy in pediatric INS. More... »

PAGES

1605-1614

References to SciGraph publications

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  • 2020-05-07. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome in PEDIATRIC NEPHROLOGY
  • 2016-01-14. Validation of a modified thromboelastometry approach to detect changes in fibrinolytic activity in THROMBOSIS JOURNAL
  • 2002-08-01. Surface markers of platelet function in idiopathic nephrotic syndrome in children in PEDIATRIC NEPHROLOGY
  • 2020-05-11. Evaluation of coagulation function by rotation thromboelastometry in critically ill patients with severe COVID-19 pneumonia in JOURNAL OF THROMBOSIS AND THROMBOLYSIS
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    http://scigraph.springernature.com/pub.10.1007/s00467-021-05366-4

    DOI

    http://dx.doi.org/10.1007/s00467-021-05366-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1144518846

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34997323


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