Urinary fibrin-fibrinogen degradation products in nephrotic syndrome.

Fibrinogen fragments (X, Y, D and E) and fibrin fragments (D-dimer and E) were examined in the urine of 52 patients with various types of renal diseases. One or more of the fibrinogen fragments were detectable in all the urine specimens. D-Dimer together with fibrinogen fragments was found in 38 of the 52 patients. The clearance ratio of D-dimer to IgG, which indicates D-dimer generated in the kidney, was lower than 1 in all the patients with the minimal changes nephrotic syndrome, and was greater than 1 in the majority of patients with acute glomerulonephritis, rapidly progressive glomerulonephritis, mesangial proliferative glomerulonephritis and membranoproliferative glomerulonephritis. Our results suggest that urinary fibrin/fibrinogen degradation products (FDP) in renal diseases are derived primarily from increased filtration of FDP from the plasma through a damaged glomerular basement membrane, and that the mechanism of lysis of cross-linked fibrin deposited in the glomeruli occurs simultaneously in some types of glomerulonephritis. It seems that the determination of the clearance ratio of D-dimer to IgG may be useful in assessing the activation of the coagulation and fibrinolysis systems in the kidney in patients with renal diseases.

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Urinary Fibrinogen and Fibrin Fragments in Children with Renal Disease

Yoshioka¹,

Iseki²,

Akano³

et al. 1982

“…In clinical practice, FDP and. especially, urinary FDP have been utilized as indexes of these abnormalities [5][6][7][8]. Referring to urinary FDP, we have previously reported some results [14.…”

Section: Discussionmentioning

confidence: 94%

Significance of Urinary Fibrin/Fibrinogen Degradation Products in Renal Diseases Measured by a Highly Sensitive ELISA

Shibata¹,

Magari

Perparim³

et al. 1995

The urinary fibrin/fibrinogen degradation products (FDP), as sensitive indicators of various renal disorders, have been measured by several methods. For their determination, a new and highly sensitive enzyme-linked immunosorbent assay not requiring the urine concentration has been developed. The study comprised 42 patients with nonnephrotic chronic glomerulonephritis (CGN), 23 patients with primary nephrotic syndrome (NS), and 29 healthy adults. The results were as follow: (1) the content of urinary FDP in normal subjects was 10.30 ± 9.08 ng/ ml; (2) the mean level of urinary FDP in both CGN and NS groups was significantly higher than in normal subjects; (3) in the CGN group itself there was a tendency for an increase of urinary FDP during more active forms of the disease, and (4) there was a significant correlation between urinary FDP and urinary protein in the CGN group, whereas no correlation was observed in the NS group. These results suggest that the major part of urinary FDP in the CGN group derives from the increased filtration, while its origin in the NS group is not related to increased filtration only, but may also have involved intraglomerular coagulation abnormalities. The newly developed enzyme-linked immunosorbent assay can detect urinary FDP levels lower than 3.9 ng/ml. Therefore, this method can be of great value in determining the degree of abnormalities of intraglomerular coagulation and fibrinolysis in renal diseases.

“…It is of interest that an enhanced fibri nolytic activity was recorded even in the hypercoagulable state in the nephrotic syndrome. The elevated urinary FDP is considered to be attributed to a leakage of cir culating FDP through the glomerular basement mem brane [3].…”

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Embolism Occurring with Corticosteroid and Diuretics Therapy in a Minimal-Change Nephrotic Patient

Shimamatsu¹,

Onoyama²,

Maeda³

et al. 1982

A 32-year-old female with a relapsing minimal-change nephrotic syndrome developed a massive pulmonary embolism during the treatment of prednisolone and diuretics. The use of diuretics in addition to a hypercoagulable state associated with nephrotic syndrome per se and corticosteroid was considered to be a direct causative factor for the event. The careful use of diuretics and a consideration of additional anticoagulant therapy are emphasized.