Kuhlmann U, Blättler W, Pouliadis G, Siegenthaler W
Schweiz Med Wochenschr. 1979 Feb 10;109(6):200-9.
The nephrotic syndrome may be associated with several complications caused by severe proteinuria. The consequences of severe renal protein loss are disturbances of water and electrolyte metabolism, thromboses and thromboembolic complications, hyperlipidemia with accelerated atherosclerosis and, finally, some other complications due to the decreased oncotic pressure and the renal loss of transport globulins and immunoglobulins. Diagnosis and treatment of these complications are important in the management of patients with nephrotic syndrome. In the present study, the frequency and localization of thromboses and thromboembolic complications in 11 patients with nephrotic syndrome are described. In addition, factors which are known to be responsible for the hypercoagulable state in nephrotic syndrome were evaluated and correlated to the thromboembolic complications in these patients. An important finding was that in all patients with thromboses and thromboembolic complications, the serum albumin concentrations were below 2 g/100 ml, whereas, with one exception, serum albumin levels were above 2 g/100 ml in cases without thromboembolic complications. Our results indicate that serum albumin levels may be used as an indirect parameter to assess the risk of thromboembolic complications in patients with nephrotic syndrome.
肾病综合征可能与严重蛋白尿引起的几种并发症相关。严重肾性蛋白丢失的后果包括水和电解质代谢紊乱、血栓形成及血栓栓塞并发症、伴有动脉粥样硬化加速的高脂血症，以及最终因胶体渗透压降低和转运球蛋白及免疫球蛋白的肾性丢失导致的其他一些并发症。这些并发症的诊断和治疗在肾病综合征患者的管理中很重要。在本研究中，描述了11例肾病综合征患者血栓形成及血栓栓塞并发症的发生频率和部位。此外，对已知导致肾病综合征高凝状态的因素进行了评估，并将其与这些患者的血栓栓塞并发症相关联。一个重要发现是，所有有血栓形成及血栓栓塞并发症的患者，血清白蛋白浓度均低于2g/100ml，而在无血栓栓塞并发症病例中，除1例例外，血清白蛋白水平均高于2g/100ml。我们的结果表明，血清白蛋白水平可作为评估肾病综合征患者血栓栓塞并发症风险的间接参数。
