Thrombotic Risk in Children with Idiopathic Nephrotic Syndrome in Abidjan, Ivory Coast

Aims: The objective of this study was to evaluate the thrombotic risk in children of Abidjan suffering with the idiopathic nephrotic syndrome (INS).

Study Location and Period: This study was conducted in 56 children with INS, aged 24 to 144 months and followed up at the pediatric nephrology unit of the University Hospital of Yopougon. It took place from January 2021 to April 2022. Blood samples were taken in that unit for each child. Blood counts and albumin levels were performed at the laboratory of biology and medical research of the National Institute of Public Health (INSP) in Adjamé. Fibrinogen, factors V, VII, VIII, IX, antithrombin III (ATIII), protein C, protein S and D-dimers were measured at Laboratory Longchamp of Plateau.

Methodology: In each child, blood samples were collected by venipuncture on dry tubes, with sodium citrate and EDTA. Blood counts were performed on Sysmex XT 2000i, albumin levels on Cobas C311 and haemostasis parameters on Sysmex CS1600.

Results: Of the 56 children recruited, hypoalbuminemia < 30 g/L was found in 35 (62.5%) children. The most common haemostasis abnormalities were increased D-Dimer in 35 (62.5%) children, hyperfibrinemia in 34(60.7%) children, increased protein C in 31 (55.3%) children, thrombocytosis in 29 (51.8%) children. ATIII and protein S deficiencies were found in 16 (28.6%) and 11 (19.6%) children respectively. Thrombosis risk was present in 36 (64.3%) children. A significant association was found between albuminemia < 20 g/L and ATIII < 70%.

Conclusion: There is a thrombotic risk in children with INS, which may be increased by hypoalbuminemia < 20 g/L.