Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis

Background. Nephrotic syndrome (NS) is associated with a high risk of thrombotic complications. In this group of patients, routine local tests for assessing hemostasis do not accurately reflect hypercoagulable state. Global functional tests for assessing hemostasis, including thrombodynamics (TD), a...

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Main Authors: Natalia V. Chebotareva, Evgenia A. Kharionovskaya, Evgenia A. Biryukova, Svetlana A. Berns, Tatiana A. Vuimo
Format: Article
Language:Russian
Published: "Consilium Medicum" Publishing house 2024-01-01
Series:Терапевтический архив
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Online Access:https://ter-arkhiv.ru/0040-3660/article/viewFile/634083/149172
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author Natalia V. Chebotareva
Evgenia A. Kharionovskaya
Evgenia A. Biryukova
Svetlana A. Berns
Tatiana A. Vuimo
author_facet Natalia V. Chebotareva
Evgenia A. Kharionovskaya
Evgenia A. Biryukova
Svetlana A. Berns
Tatiana A. Vuimo
author_sort Natalia V. Chebotareva
collection DOAJ
description Background. Nephrotic syndrome (NS) is associated with a high risk of thrombotic complications. In this group of patients, routine local tests for assessing hemostasis do not accurately reflect hypercoagulable state. Global functional tests for assessing hemostasis, including thrombodynamics (TD), are considered promising for assessing disorders in the blood coagulation system of these patients. Aim. To compare the rate of hypercoagulability according to routine hemostatic tests and TD and to evaluate the factors associated with increased risk of thrombotic complications in patients with chronic glomerulonephritis (CGN). Materials and methods. The study included 94 patients with active CGN who were not receiving anticoagulant therapy; 63 (80.3%) patients had NS, and 31 (19.7%) had active CGN without NS. Hemostasis parameters were assessed using local coagulation tests and TD test. Using logistic regression analysis, factors associated with the risk of thrombosis were assessed. Results. Of the 94 patients with active CGN in 63 without preventive anticoagulant therapy, hypercoagulability according to routine tests was detected in 6 (9.5%) patients with NS and in 3 (9.7%) patients without NS (p0.05). Hypercoagulability according to the TD test was detected in 24 (53.9%) patients with NS and in 5 (32.2%) without NS (p0.05). The formation of spontaneous clots was observed in 29 (30.9%) of patients with CGN, most of them 24 (83%) with NS. 10.6% of patients in our cohort experienced thromboembolic events. The risk of thromboembolic events according to the univariate regression analysis was associated with older age, higher lipid levels, use of glucocorticosteroids and detection of spontaneous clots by the TD test. No association of thromboembolic events with abnormalities in routine hemostasis tests was obtained. Conclusion. In patients with CGN with nephrotic syndrome, hypercoagulability is detected in 9.5% of cases with routine coagulation tests and in 53.9% of cases with TD test. Detection of spontaneous clots by TD test is associated with a risk of thromboembolic events.
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spelling doaj-art-478b5d5619bb484c8bc427ae788e3d0e2025-08-20T02:20:16Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422024-01-0196656557010.26442/00403660.2024.06.20272378508Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritisNatalia V. Chebotareva0https://orcid.org/0000-0003-2128-8560Evgenia A. Kharionovskaya1https://orcid.org/0009-0008-8777-5007Evgenia A. Biryukova2https://orcid.org/0009-0005-8284-3136Svetlana A. Berns3https://orcid.org/0000-0003-1002-1895Tatiana A. Vuimo4https://orcid.org/0000-0003-3491-1884Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)National Medical Research Center for Therapy and Preventive MedicineCenter for Theoretical Problems of Physico-Chemical PharmacologyBackground. Nephrotic syndrome (NS) is associated with a high risk of thrombotic complications. In this group of patients, routine local tests for assessing hemostasis do not accurately reflect hypercoagulable state. Global functional tests for assessing hemostasis, including thrombodynamics (TD), are considered promising for assessing disorders in the blood coagulation system of these patients. Aim. To compare the rate of hypercoagulability according to routine hemostatic tests and TD and to evaluate the factors associated with increased risk of thrombotic complications in patients with chronic glomerulonephritis (CGN). Materials and methods. The study included 94 patients with active CGN who were not receiving anticoagulant therapy; 63 (80.3%) patients had NS, and 31 (19.7%) had active CGN without NS. Hemostasis parameters were assessed using local coagulation tests and TD test. Using logistic regression analysis, factors associated with the risk of thrombosis were assessed. Results. Of the 94 patients with active CGN in 63 without preventive anticoagulant therapy, hypercoagulability according to routine tests was detected in 6 (9.5%) patients with NS and in 3 (9.7%) patients without NS (p0.05). Hypercoagulability according to the TD test was detected in 24 (53.9%) patients with NS and in 5 (32.2%) without NS (p0.05). The formation of spontaneous clots was observed in 29 (30.9%) of patients with CGN, most of them 24 (83%) with NS. 10.6% of patients in our cohort experienced thromboembolic events. The risk of thromboembolic events according to the univariate regression analysis was associated with older age, higher lipid levels, use of glucocorticosteroids and detection of spontaneous clots by the TD test. No association of thromboembolic events with abnormalities in routine hemostasis tests was obtained. Conclusion. In patients with CGN with nephrotic syndrome, hypercoagulability is detected in 9.5% of cases with routine coagulation tests and in 53.9% of cases with TD test. Detection of spontaneous clots by TD test is associated with a risk of thromboembolic events.https://ter-arkhiv.ru/0040-3660/article/viewFile/634083/149172nephrotic syndromehypercoagulabilityroutine hemostasis teststhrombodynamic testthromboembolic events
spellingShingle Natalia V. Chebotareva
Evgenia A. Kharionovskaya
Evgenia A. Biryukova
Svetlana A. Berns
Tatiana A. Vuimo
Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
Терапевтический архив
nephrotic syndrome
hypercoagulability
routine hemostasis tests
thrombodynamic test
thromboembolic events
title Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
title_full Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
title_fullStr Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
title_full_unstemmed Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
title_short Comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
title_sort comparison of thrombodynamic methods and routine hemostasis tests in the evaluation of hypercoagulable syndrome in chronic glomerulonephritis
topic nephrotic syndrome
hypercoagulability
routine hemostasis tests
thrombodynamic test
thromboembolic events
url https://ter-arkhiv.ru/0040-3660/article/viewFile/634083/149172
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