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 |
Externí odkaz: |