Thromboembolic complications in nephrotic syndrome

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This review devoted to the nephrotic syndrome (NS) subsequent thrombotic outcomes. The pathogenesis of hypercoagulation disorders that cause venous and arterial vascular system thrombosis are studied. Discussed procoagulant and anticoagulant mechanisms imbalance due to the anticoagulants natural urinal loss, affected by disfunction of the glomerular filter selective permeability, leading to high molecular weight liver-derived proteins (at least of the albumin size) leakage, fibrinolysis depression, excessive liver synthesis of plasma clotting cascade factors and platelet activation. Presented new data on the thrombogenesis at NS concerning the role of endothelial microparticles with high prothrombogenic activity that go from damaged glomerulus endothelial capillary cells into the systemic circulation, which can turn the local renal hypercoagulation (concomitant to the kidney immune inflammation process) into the generalized, working towards the thrombosis development. The most frequent adverse variants of arterial and venous thromboses are studied, specified their basic and general risk factors, as well as individual, varying in different patients. Indications and prophylactic anticoagulant therapy regimen and thrombosis treatment duration in patients with NS are discussed. It also stressed that the decision on time and method of anticoagulant therapy for a NS patients is still a challenge for healthcare providers.

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About the authors

Larisa A. Bobrova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
ORCID iD: 0000-0001-6265-4091

Russian Federation, Moscow

к.м.н., ассистент каф. внутренних, профессиональных болезней и ревматологии

Natalia L. Kozlovskaya

People’s Friendship University of Russia; Yeramishantsev City Clinical Hospital

ORCID iD: 0000-0002-4275-0315

Russian Federation, Moscow

д.м.н., проф., каф. внутренних болезней с курсами кардиологии и функциональной диагностики, рук. Центра помощи беременным женщинам с патологией почек 


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