Prophylactic anticoagulation in nephrotic syndrome prevents thromboembolic complications

Autor: Henrik Birn, Jon Waarst Gregersen, Karen Marie Nykjær, Sarah Kelddal
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Nephrology
Male
Nephrotic Syndrome
endocrine system diseases
Deep vein
medicine.medical_treatment
Biopsy
Denmark
030232 urology & nephrology
030204 cardiovascular system & hematology
lcsh:RC870-923
Kidney
Kidney/pathology
0302 clinical medicine
Glomerulonephritis
Hemorrhage/chemically induced
Medicine
Anticoagulants/administration & dosage
Thromboembolic event
Heparin
Low-Molecular-Weight/administration & dosage
food and beverages
Middle Aged
Chemoprevention/methods
Thrombosis
Biopsy/methods
humanities
Pulmonary embolism
medicine.anatomical_structure
Nephrotic Syndrome/complications
Female
Thromboembolism/diagnosis
medicine.drug
Research Article
medicine.medical_specialty
education
Nephrotic syndrome
Hemorrhage
Chemoprevention
Risk Assessment
Warfarin/administration & dosage
03 medical and health sciences
Anticoagulation
Internal medicine
health services administration
Thromboembolism
Albuminuria
Humans
Renal replacement therapy
business.industry
Renal vein thrombosis
Warfarin
Anticoagulants
Heparin
Low-Molecular-Weight
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
Denmark/epidemiology
business
Zdroj: BMC Nephrology
Kelddal, S, Nykjær, K M, Gregersen, J W & Birn, H 2019, ' Prophylactic anticoagulation in nephrotic syndrome prevents thromboembolic complications ', BMC Nephrology, vol. 20, no. 1, 139, pp. 1-6 . https://doi.org/10.1186/s12882-019-1336-8
Kelddal, S, Nykjær, K M, Gregersen, J W & Birn, H 2019, ' Prophylactic anticoagulation in nephrotic syndrome prevents thromboembolic complications ', BMC Nephrology, vol. 20, no. 1, 139 . https://doi.org/10.1186/s12882-019-1336-8
BMC Nephrology, Vol 20, Iss 1, Pp 1-6 (2019)
Kelddal, S, Nykjær, K M, Gregersen, J W & Birn, H 2019, ' Prophylactic anticoagulation in nephrotic syndrome prevents thromboembolic complications ', BMC Nephrology, vol. 20, no. 1, pp. 139 . https://doi.org/10.1186/s12882-019-1336-8
ISSN: 1471-2369
Popis: BACKGROUND: An increased incidence of thromboembolic events (TE) are reported in nephrotic syndrome (NS) leading to recommendations for prophylactic anticoagulation (PAC). However, as no randomized clinical trial has established the efficacy or risks associated with PAC, guidelines are empiric or substantiated only by estimates of risks and benefits. This study evaluates the risk of TE and hemorrhagic complications in patients with NS treated with PAC and compares to patients not receiving PAC.METHODS: We included patients diagnosed with NS from two Danish nephrology departments with different practices for the use of PAC. Patients were included if presenting with NS from September 2006 to January 2012, a P-albumin RESULTS: Of the 79 patients included, 44 patients received PAC either as low or high dose low-molecular-weight heparin (LMWH) or as warfarin with or without LMWH as bridging, while 35 did not receive PAC. P-albumin was significant lower in the PAC group compared to those not receiving PAC. Significantly more TEs was observed in the non-PAC group compared to the PAC group (4 versus 0 episodes, P = 0.035). The TEs observed included one patient with pulmonary embolism (PE), one with PE and deep vein thrombosis, one with PE and renal vein thrombosis, and one with a stroke. Five patients with bleeding episodes were identified among those receiving PAC, of which two were major and three were minor, while two patients in the non-PAC group experienced a minor bleeding episode (P = 0.45 between groups). The major bleeding episodes only occurred in patients receiving PAC in combination with low dose aspirin.CONCLUSIONS: In patients with NS the use of PAC was associated with a decreased risk of clinically significant TE, but may also be associated with more bleeding episodes although not statistically significant. Only patients treated with PAC in combination with anti-platelet therapy had major bleeding episodes.
Databáze: OpenAIRE
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