Molecular Markers of Hemostasis Activation in Nephrotic Syndrome

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Abstract
Fibrinopeptide A (FPA), a sensitive index of in vivo thrombin activity,.beta.-thromboglobulin (.beta.TG) and platelet factor 4 (PF4), specific markers of platelet intravascular activation, have been measured in plasma by radioimmunoassays in 23 patients with neprhotic syndrome and in 32 normal subjects. FPA concentration was 2.40 .+-. 1.42 ng/ml (mean .+-. SD) in nephrotic patients and 1.16 .+-. 0.58 ng/ml in normal controls (p < 0.001); .beta.TG concentration was 57.9 .+-. 33.2 ng/ml in nephrotic patients and 25.7 .+-. 7.4 ng/ml in controls (p < 0.001); PF4 level was not different from controls. These data indicate in vivo blood hypercoagulability and platelet hyperfunction in nephrotic syndrome. Moreover, we have documented a slow in vitro FPA generation pattern (.DELTA.FPA): 0.97 .+-. 0.512 ng/ml/10 min; this suggests that thrombin activity is predominantly local.