Nissar Syed M, Kuchay Abid A, Mir Tajamul H, Goud L Naresh, Latief Muzamil
Nephrology Division, Super Specialty Hospital, Government Medical College, Srinagar, Jammu and Kashmir, India.
Cancer Research, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India.
Indian J Nephrol. 2024 Mar-Apr;34(2):169-171. doi: 10.4103/ijn.ijn_317_22. Epub 2023 Sep 20.
Nephrotic syndrome (NS) is one of the common presentations of kidney diseases both in children and adults. NS patients, particularly those with membranous nephropathy, have increased risk of thromboembolic events. Heparin and vitamin K antagonists (VKAs) continue to be commonly used as prophylactic and therapeutic agents, given the experience of use of these agents in NS and nonrenal indications of anticoagulation. The use of direct oral anticoagulants (DOACs) in NS is reported in some case series, conference abstracts, and a few small studies. We report our experience of using DOACs in 11 patients of NS with severe hypoalbuminemia. Out of 11, one patient required change of anticoagulation from DOACs to VKA and the rest of them did well with DOACs. There were no bleeding episodes in our study. We suggest larger studies to be carried out to better understand the use of these agents in NS.
肾病综合征（NS）是儿童和成人肾脏疾病的常见表现之一。NS患者，尤其是膜性肾病患者，发生血栓栓塞事件的风险增加。鉴于这些药物在NS及非肾脏抗凝适应症中的使用经验，肝素和维生素K拮抗剂（VKAs）仍然是常用的预防和治疗药物。一些病例系列、会议摘要和少数小型研究报告了NS患者使用直接口服抗凝剂（DOACs）的情况。我们报告了11例重度低白蛋白血症NS患者使用DOACs的经验。11例患者中，1例需要将抗凝药物从DOACs改为VKA，其余患者使用DOACs效果良好。我们的研究中没有出血事件发生。我们建议开展更大规模的研究，以更好地了解这些药物在NS中的应用。
