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Determination of the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the diagnosis of asymptomatic pulmonary embolism in patients with nephrotic syndrome

Abstract

Background

Thromboembolism is one of the most important and dangerous complications of nephrotic syndrome. This study aimed to determine the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the prediction of asymptomatic pulmonary embolism in patients with nephrotic syndrome in non-remission period.

Methods

Plasma levels of albumin, anti-thrombin III, fibrinogen and D-dimer were assessed in 30 nephrotic children in non-remission period (including new case–patient or relapse period), and the results were compared with chest X-ray and lung perfusion scintigraphy (Q scan).

Results

The mean age of patients was 6.22 ± 3.5 years (range 2–12 years). Of patients, 23.3% had abnormal findings in perfusion scan suggestive of pulmonary emboli despite absence of any respiratory manifestations. Median plasma albumin and anti-thrombin III levels in patients with asymptomatic pulmonary embolism were lower than in patients without pulmonary embolism. Also, median fibrinogen and D-dimer levels in patients with asymptomatic pulmonary embolism were higher than in patients without pulmonary embolism, with no statistically significant differences between sex, age, hemoglobin and hematocrit of patients and lung perfusion scan results.

Conclusion

Patients with abnormal blood levels of albumin (< 3.5 g/dl), anti-thrombin III (< 80 ml/dl), fibrinogen (> 400 ml/dl) and D-dimer (> 0.5 μg/dl) underwent CXR/Q scan and were treated with heparin if there was pulmonary embolism.

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Fig. 1

Data availability

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank staff of the Ali Asghar Hospital of Iran University of Medical Sciences (Iran) for their cooperation throughout the period of study.

Funding

The study was supported by Deputy of Research of Iran University of Medical Sciences, Tehran, Iran.

Author information

Affiliations

Authors

Contributions

Conceptualization: Rozita Hosseini shamsabadi; methodology: Hasan Otukesh; formal analysis and investigation: Amin Sadat Sharif and Maryam Sakhaei; writing—original draft preparation: Amin Sadat Sharif; writing—review and editing: Nasrin Hoseiny nejad, Rozita Hosseini shamsabadi and Sepideh Hekmat.

Corresponding author

Correspondence to Amin Sadat Sharif.

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Competing interests

The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects. Ethical approval was elicited from the Ethical Committee at the Iran University of Medical Sciences in Iran, and parents/patients gave informed consent.

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Hoseiny nejad, N., Sharif, A.S., Otukesh, H. et al. Determination of the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the diagnosis of asymptomatic pulmonary embolism in patients with nephrotic syndrome. Pediatr Nephrol 36, 1803–1808 (2021). https://doi.org/10.1007/s00467-020-04904-w

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Keywords

  • Nephrotic syndrome
  • Pulmonary embolism
  • CXR/Q scan
  • Albumin
  • Anti-thrombin III
  • Fibrinogen
  • D-Dimer