Platelet functions, plasma fibrinolytic activity and coagulation screen findings in Africans with nephrotic syndrome without uraemia, as seen at the Kenyatta National Hospital (KNH)

Abstract

In a nine months period,from March 1987 to November

1987, inc1usiv€, studies on p1ac21et functions, pla$ma fibrinolytic activity and coagulation screen were carried out in 40 patients (30 males and 10 females) with the nephrotic syndrome and 40 matches controls at the Kenyatta National Hospital. The age range was S-Sl years, mean + SD

20.5+11.6.

patients had unchanged platelet counts and clot retraction compared to controls (p>O.OS), whereas platelet adhesiveness and platelet agg~egation to adenosine diphosphate U",DP) were significantly reduced among patients (P<O.OOl). patients had in addition significantly shortened bleeding tiIT~s. The prothrombin time was not different, whereas the thrombin time was significantly prolonged (P<0.05) and the partial t h rc rnboplast i n time shortened (p<O.OOl), in patients compared to controls. Significant reduction in pla.sma fibrinolytic activity associated with elevated plasma fibrinogen levels were found among patients (P<O.OOl). .Significant negative correlations were observedbet ween :

total serum cholesterol and serum albumin (r= -0.79

P<O.OOl), fibrinolytic activity and total serum cholesterol (r= -0.S3, P<O.OOl), and between plasma fibrinogen concentration and serum albumin (r= -0.57, P<O.OOl). Insignificant positive correlations were noted between

fibrinolytic ac ivity and serum albumin (r=O.l, P>0.05) as well as between plasma fibrinogen concentration and total cholesterol (r=0.25, P>0.05). It is concluded that our patients have a degree of hype-rcoagulability. Whether the factors for and against hypercoagulabiJ .ity compensate f cr each other in the causation of complications need to be verified. A larger populatibn and more detailed haemostatic study will in future be needed to cover more nephrotic patients in different areas of the country. It is also necessary to folIo w up ou r pat ient s f or complicat ions resul ting from this hypercoagulable state, like thromboembolic events and

is.c!haemic heart diseas.e to find ou.t.. their pre...lence .

and

contr.ibutionto morbidity and mortality among Africans with

nephrotic syndrome.