Kanfer A
Service de Néphrologie A, Hôpital Tenon, Paris.
Nephrologie. 1992;13(4):151-7.
Thromboses and disorders of hemostasis in nephrotic syndrome. Thromboembolic complications are common in nephrotic syndrome (NS). This article reviews the factors of thrombogenesis in NS, including: 1) a hypercoagulable state with platelet hyperaggregability, hyperfibrinogenemia and elevated factor VIII, decrease in plasma levels of coagulation inhibitors antithrombin III and free protein S, reduced fibrinolytic activity; 2) excessive intravascular thrombin formation marked by increased plasma levels of fibrinopeptide A. The intensity of hemostasis disorders coincides with that of NS. Most disorders are related to hypoalbuminemia and proteinuria. In agreement with experimental data, the role of intraglomerular activation of coagulation during active phases of glomerulopathies has to be considered. This could explain the predominance of renal vein thrombosis in several glomerulopathies with NS. Several coagulation disorders in SN have implications for therapy.
肾病综合征中的血栓形成与止血障碍。血栓栓塞并发症在肾病综合征（NS）中很常见。本文综述了NS中血栓形成的因素，包括：1）高凝状态，伴有血小板高聚集性、高纤维蛋白原血症和因子VIII升高，血浆中凝血抑制剂抗凝血酶III和游离蛋白S水平降低，纤溶活性降低；2）以血浆纤维肽A水平升高为特征的血管内凝血酶过度形成。止血障碍的严重程度与NS一致。大多数障碍与低白蛋白血症和蛋白尿有关。与实验数据一致，必须考虑肾小球病活动期肾小球内凝血激活的作用。这可以解释在几种伴有NS的肾小球病中肾静脉血栓形成的优势。NS中的几种凝血障碍对治疗有影响。
