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In vivo measurements of fibrin formation and degradation in nephrotic patients

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International Journal of Clinical and Laboratory Research

Summary

Intraglomerular fibrin deposition has been implicated as an important pathogenetic mechanism in patients with glomerular diseases and the nephrotic syndrome. To investigate fibrin formation and degradation in nephrosis, we measured fibrinopeptide A by radio-immunoassay and D-dimer by enzyme-linked immunosorbent assay in the plasma of 30 consecutive adult patients with the nephrotic syndrome; in 10 the serum creatinine was more than 2 mg/dl. Both fibrinopeptide A and D-dimer were abnormally elevated in the majority of nephrotics (P<0.001 vs. healthy controls), providing evidence of increased fibrin generation and lysis “in vivo.” A positive correlation was found between fibrinopeptide A and D-dimer (correlation coefficient 0.64,P<0.001), suggesting a close relationship between fibrin formation and degradation. Calcium heparin, administered to 12 nephrotics, caused a marked decrease in plasma fibrinopeptide A, due to a reduction of in vivo thrombin activity. As enhanced thrombin activity can favor fibrin deposition within the renal parenchyma, as well as vascular complications, it is reasonable to assume that an antithrombotic treatment aimed at controlling thrombin generation may ameliorate the natural history of nephrosis.

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Authors and Affiliations

  1. Ist Clinical Medicine Institute, University Hospital, Via Roma 67, 1-56126, Pisa, Italy

    Andrea Sagripanti, Adamasco Cupisti & Giuliano Barsotti

  2. Blood Bank, University Hospital, Via Roma 67, I-56126, Pisa, Italy

    Ugo Baicchi

  3. Nuclear Medicine Service, University Hospital, Via Roma 67, I-56126, Pisa, Italy

    Marco Ferdeghini

Authors
  1. Andrea Sagripanti
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  2. Adamasco Cupisti
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  3. Ugo Baicchi
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  4. Marco Ferdeghini
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  5. Giuliano Barsotti
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Sagripanti, A., Cupisti, A., Baicchi, U. et al. In vivo measurements of fibrin formation and degradation in nephrotic patients. Int J Clin Lab Res 24, 113–116 (1994). https://doi.org/10.1007/BF02593911

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  • DOI: https://doi.org/10.1007/BF02593911

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