Nephrology Dialysis Transplantation, Vol 12, Issue 8 1680-1683, Copyright © 1997 by Oxford University Press
A Irish
Background: Acquired abnormalities of coagulation and
fibrinolysis in nephrotic syndrome have been implicated in the pathogenesis
of renal vein thrombosis (RVT). Whether resistance to activated Protein C
due to a mutation in the gene for factor V (FV Leiden/FV506Q, the commonest
inherited risk factor for venous thrombosis) could contribute to risk of RT
in patients with nephrotic syndrome is unknown.
Method: Genotyping for the factor V Leiden mutation
was undertaken in a retrospective study of 35 patients with a history of
nephrotic syndrome, 10 of whom had suffered clinically significant and
radiologically proven RVT. Results: Two patients (6%)
were heterozygous for the FV506Q mutation, a prevalence similar to studies
within the general population. One heterozygote had suffered a RVT, whilst
the other without a native RVT subsequently had a primary renal allograft
thrombosis. Conclusion: In a retrospective study the
prevalence of the FV Leiden mutation was not increased in patients with
nephrotic syndrome nor associated with prevalence of clinically significant
RVT. Whilst this study was insufficiently powerful to fully exclude an
association, it suggests acquired rather than inherited alterations in the
coagulation/fibrinolytic balance associated with nephrosis may be of
greater importance in venous thrombotic risk, and that routine screening of
patients with nephrosis for this mutation will not identify the majority of
patients at risk for RVT. Confirmation of these results and determining
whether the natural history of thrombosis or underlying renal disease in
carriers of the FV Leiden mutation differs from those without this
mutation, will require a large prospective study.
Keywords: Nephrotic syndrome; renal vein thrombosis;
factor V Leiden mutation
PRELIMINARY REPORTS
The factor V Leiden mutation and risk of renal vein thrombosis in patients with nephrotic syndrome
Oxford Renal Unit, The Churchill Hospital, Headington, Oxford OX3 7LJ, UK; Corresponding address: Department of Nephrology, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia, 6001, Australia
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