The Crosstalk between Nephropathy and Coagulation Disorder: Pathogenesis, Treatment, and Dilemmas.

Abstract

ABSTRACT:

The interaction between the kidney and the coagulation system greatly affects each other because of the abundant vessel distribution and blood perfusion in the kidney. Clinically, the risks of complicated thrombosis and bleeding have become important concerns in the treatment of nephropathies, especially nephrotic syndrome, CKD, ESKD, and patients with nephropathy undergoing RRTs. Adverse effects of anticoagulant or procoagulant therapies in patients with nephropathy, especially anticoagulation-related nephropathy, heparin-induced thrombocytopenia, and bleeding, seriously worsen the prognosis of patients, which have become challenges for clinicians. Over the decades, the interaction between the kidney and the coagulation system has been widely studied. However, the effects of the kidney on the coagulation system have not been systematically investigated. Although some coagulation-related proteins and signaling pathways have been shown to improve coagulation abnormalities while avoiding additional kidney damage in certain kidney diseases, their potential as anticoagulation targets in nephropathy requires further investigation. Here, we review the progression of research on the crosstalk between the coagulation system and kidney diseases and systematically analyze the significance and shortcomings of previous studies to provide new sight into future research. In addition, we highlight the status of clinical treatment for coagulation disorder and nephropathy caused by each other, indicating guidance for the formulation of therapeutic strategies or drug development.

• Authors: Zhiwei Qiu, Xiaocong Pang, Qian Xiang, Yimin Cui
• Journal: Journal of the American Society of Nephrology : JASN (J Am Soc Nephrol) Vol. 34 Issue 11 Pg. 1793-1811 (11 01 2023) ISSN: 1533-3450 [Electronic] United States
• PMID: 37487015 (Publication Type: Review, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology.

Chemical References

• Anticoagulants
• Blood Coagulation Factors
• Heparin

Topics

• Humans
• Blood Coagulation Disorders (complications, drug therapy)
• Anticoagulants (adverse effects)
• Kidney
• Nephrotic Syndrome (drug therapy)
• Thrombosis (complications)
• Blood Coagulation Factors
• Hemorrhage
• Heparin (adverse effects)