الفهرس 
Nephrotic syndromeOnly 14 pages are availabe for public view
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Abstract
Nephrotic syndrome is one of the most common kidney problems. Diagnostic criteria include proteinuria ( 3.5g/day), hypoalbuminemia, edema, hyperlipidemia and lipiduria.
Hemostasis is a complex process of inhibition of blood loss through combined action of platelets, coagulation factors and blood vessels integrity. A critical balance between clot activating, inhibiting and lysing factors is essential.
Thrombosis results when hemostasis occur at an inappropriate time or place. There are three natural anticoagulant mechanisms that control thrombus formation. These include AT III, protein C pathway and fibrinolytic system.
In patients with nephrotic syndrome there are increased tendency to thrombotic complications including both venous and arterial side. The aim of this work is to evaluate some natural anticoagulaents (AT III, protein C, protein S) in a trial to find out any changes leading to thrombosis, bleeding and/or both.
Twenty patients with nephrotic syndrome diagnosed on the grounds of clinical, laboratory and biopsy studies were included in our work. Ten healthy well matched persons were taken as controls.
• Patients and controls were subjected to the following.
1- Full history and clinical examination.
2- Laboratory investigations.
• Serum creatinine.
• Urinary proteins in grams per 24 hours.
• Serum albumin.
• Prothrombin time.
• Activated partial thromboplastin time.
• Antithrombin III.
• Protein C concentration.
• Protein S concentration.
3- Abdominal ultrasonagraphy.
4- Renal biospsy (for nephrotic patients only).
• The results of our study declared the following data in nephrotic patients.
o Short P.T, P.T.T
o Decreased levels of serum AT III.
o High levels of serum protein C and protein S.
o Negative correlation between AT III and 24 hours urinary proteins.
o Positive correlation between both protein C and protein S and 24 hours urinary proteins.
o Negative correlation between both protein C, protein S and P.T.
o Negative correlation between both protein C, protein S and P.T.T.
It could be concluded that there is a hypercoagulable state in nephrotic syndrome as evidenced by short P.T, P.T.T and low levels of AT III. High levels of protein C and protein S might be due to elevated bound forms of both proteins insipite of urinary loss of free forms.
It is recommended to evaluate other haemostatic parameters including coagulation system proper, platelet functions and fibrinolytic system activities in addition to natural anticoagulants to identify the whole picture of haemostatic deragments in nephrotic patients. Moreover evaluation of the effect of prophalyactic anticoagulants on haemostatic abnormalities and reflection on the outcome on nephrotic patients might be of paramount importance.