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Thrombosis in NS — RACP Paediatrics MCQ

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HardNephrologyThrombosis in NSRACP Paediatrics

A 3-year-old with nephrotic syndrome presents with swollen, painful right leg. D-dimer is elevated. USS Doppler confirms right femoral vein thrombosis. What predisposes nephrotic patients to thrombosis?

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Correct answer: D — Loss of antithrombin III in the urine and hypercoagulable state

Nephrotic syndrome creates a hypercoagulable state due to urinary loss of antithrombin III (and other anticoagulant proteins), elevated fibrinogen, increased platelet aggregability, and haemoconcentration from intravascular volume depletion. Venous thromboembolism risk is significant, especially renal vein thrombosis.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Nephrotic Syndrome Complications