Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2017, Vol. 26 ›› Issue (2): 108-112.DOI: 10.3969/cndt.j.issn.1006-298X.2017.02.002
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Objective:To investigate the specific manifestation and influencing factors of the coagulation disorders in patients with idiopathic membranous nephropathy (IMN). Methodology:Two hundred forty two patients with nephrotic syndrome, who were diagnosed as IMN by renal biopsy from January 2012 to September 2016 in our clinical research center, were enrolled into this respective study. Their R time, K time, α angle, MA value, and coagulation index (CI) in thrombronelastogram (TEG) were analyzed. Besides, 81 IMN patients with 24h urinary protein less than 1g were regarded as control group. Results:Significant difference was noticed in MA value between IMN with nephrotic syndrome group and control group (696 vs 651 mm,P<001), but not in R time(60 vs 61 min,P=072). With regard to IMN patients with nephrotic syndrome, correlation analysis showed that serum albumin was negatively related to MA value(r=-019,P<001), α angle(r=-016,P=001)and CI(r=-013,P=005), positively related to K time(r=012,P=006), but not related to R time(r=001,P=087). Multiple linear regression analysis indicated that serum albumin was an independent relevant factor of platelet hyperactivity in IMN. And there were no differences in all the clinical characteristics and TEG parameters between antiPLA2R(+)and antiPLA2R(-) IMN patients with nephrotic syndrome. Conclusion:Platelet hyperactivity is correlated closely to the coagulation disorders of IMN. Platelet hyperactivity is related to nephrotic syndrome state, but not PLA2R antibody. These results indicate that combination of anticoagulant and antiplatelet therapy may decrease the incidence of thromboembolic events in IMN.
Key words: idiopathic membranous nephropathy, nephrotic syndrome, platelet hyperactivity, thromboelastogram
LIU Lei,LE Weibo,XU Xiaodong,et al. Coagulation disorders and platelet hyperactivity in idiopathic membranous nephropathy[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2017, 26(2): 108-112.
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URL: http://www.njcndt.com/EN/10.3969/cndt.j.issn.1006-298X.2017.02.002
http://www.njcndt.com/EN/Y2017/V26/I2/108