Thromboembolism
Patients with nephrotic syndrome are at risk of thromboembolic disease:
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A ventilation perfusion (V-Q) scan of a nephrotic patient with an embolus occluding the right pulmonary artery |
Both arterial and venous thrombosis can develop.
The increased risk is multi-factorial and includes:
- loss of thrombolytic protein, antithrombin III in the urine
- decreased levels of protein C and S
- hyperfibrinogenaemia secondary to increased hepatic synthesis
- increase in the coagulation factors V, VII, VIII and X
- platelet hyperaggregability