HEMORHEOLOGICAL AND HEMOSTATIC PARAMETERS IN CHILDREN WITH NEPHROTIC SYNDROME UNDERGOING STEROID-THERAPY

Disturbances in hemostatic and hemorheological parameters have been investigated in a group of 29 children with nephrotic syndrome: 23 children classified as steroid-sensitive and 6 as steroid-resistant, Studies were performed before prednisone treatment and 3 weeks later, after initiation of steroid therapy. Before treatment, the alterations in hemostatic system involved moderate thrombocytosis with spontaneous aggregation in 19 patients. High levels of fibrinogen, factor VIII, Willebrand factor, protein C, protein S and alpha(2)-macroglobulin (alpha(2)M) were observed. Factor XII and alpha(1)-antitrypsin (alpha(1)AT) were lower than normal. Antithrombin III (ATIII) level was normal in the majority of patients. A plasma and blood hyper-viscosity syndrome was also observed as well as an increase in erythrocyte aggregation. During treatment, an improvement in the hemostatic parameters was observed in the patients who responded to prednisone. The expected increase in factor VIII (frequently described in the literature) was not observed, while there was a significant increase in protein C. In the steroid-resistant patients, the only significant changes observed were decreased fibrinogen and increased protein C. The hemorheological parameters showed a tendency Hemorheology towards normality regardless of whether or not the treatment provided remission Blood viscosity of NS. The relationship between hemorheological and hemostatic factors Corticosteroids changes are discussed.