BLOOD-COAGULATION AND THE NEPHROTIC SYNDROME - DEFICIENCY OR EXCESS

Normal hemostasis can be disrupted in patients with nephrotic syndrome. More commonly a thrombotic diathesis is seen but there are also sporadic reports of abnormal bleeding. These abnormalities appear to result from the abnormal protein loss, hypoalbuminemia, and hyperlipidemia that characterize the condition. Hemoconcentration, enhanced platelet aggregation, increased activity of several coagulation factors, and defective fibrinolysis collectively predispose to thrombotic complications. An acquired deficiency of some clotting factors is usually responsible for the bleeding diathesis.