Why does blood clot present in Nephrotic Syndrome? Patients with Nephrotic Syndrome are in a state of hypercoagulation due to changes in coagulation factors, especially when plasma albumin is lower than 20 ~ 25g/L, which may lead to venous thrombosis. Now go on reading to learn more detailed information.
Causes of blood clot in Nephrotic Syndrome
-Due to the decrease of effective blood volume, blood concentration and hyperlipidemia, blood viscosity increases;
-Protein loss from urine, and the increase of compensatory synthetic protein in liver, resulting in the imbalance of coagulation, anticoagulation and fibrinolysis system;
-The application of strong diuretics and other factors easily lead to intravascular thrombosis and embolism.
-If the level of serum albumin is less than 25g/L, the tendency of blood hypercoagulability is more serious, which can easily lead to renal vein thrombosis. The common sites are deep veins of lower limbs, unilateral or bilateral renal vein embolism, pulmonary infarction, etc.
Treatment of blood clot in Nephrotic Syndrome
(1) Heparin: mainly through the activation of antithrombin III (ATIII) activity. The commonly used dose of intravenous drip is 50-75 mg/d, which makes AT III activity unit more than 90%. It has been reported that heparin can reduce proteinuria and improve renal function in nephrotic syndrome, but its mechanism is not clear. It is noteworthy that heparin (MW65600) can induce platelet aggregation. Small molecular weight heparin is injected subcutaneously once a day.
(2) Urokinase (UK): Direct activation of plasminogen leads to fibrinolysis. The commonly used dose is 2-80,000 U/d. It can be used from a small dose and intravenously dripped with heparin at the same time. The dissolution time of euglobulin is monitored between 90 and 120 minutes. The main side effects of UK are allergy and bleeding.
(3) Warfarin: it inhibits the synthesis of vitamin K-dependent factors II, Ⅶ, Ⅸand X in hepatocytes at a dose of 2.5 mg/d. The time of prothrombin is monitored by oral administration to make it 50%-70% in normal subjects.
(4) Dipyridamole: it is a platelet antagonist, the commonly used dose is 100-200 mg/d. The time of venous anticoagulation in hypercoagulable state is 2-8 weeks, then warfarin or dipyridamole is taken orally.
Patients with venous thrombosis: (1) Surgical removal of thrombus.
(2) Interventional thrombolysis. Interventional radiation can dissolve renal vein thrombosis by injecting UK 240,000 U at the end of renal artery. This method can be used repeatedly.
(3) systemic venous anticoagulation. That is heparin plus urokinase for 2 to 3 months.
(4) Take warfarin orally to relieve nephrotic syndrome in order to prevent thrombosis recurrence.
Why does blood clot present in Nephrotic Syndrome? Now you get the causes and treatment. For more information on Nephrotic Syndrome, please leave a message below or contact online doctor.
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