Fibrinocoagulopathy in Diabetic Nephropathy with Hypoalbuminemia

Abstract

The effects of hypoalbuminemia on fibrinocoagulopathy in diabetics were studied.In all cases (63 NIDDM, 24 IDDM and 14 healthy controls), the overnight fasting blood sugar levels were below 200 mg/100 ml.The diabetics were divided into four groups as follows:(I) 34 patients without retinopathy, clinical signs of nephropathy (proteinuria), or hypoalbuminemia, (II) 34 patients with retinopathy (Scott I-II) but without proteinuria or hypoalbuminemia, (III) 9 patients with both retinopathy (Scott III-IV) and proteinuria, but without hypoalbuminemia, (IV) 10 patients with the same degree of retinopathy as in III, and with both proteinuria and hypoalbuminemia.
The groups were matched for age.
The overnight fasting plasma β-thromboglobulin (β-TG) levels in groups III and IV were significantly higher than those in group I. The levels of β-TG in group III were higher than those in IV, although the difference was not significant.The plasma levels of soluble fibrin monomer complexes (SFMC) in groups III and IV were significantly higher than those in group I. The SFMC levels in group IV were also significantly higher than those in group III. A positive correlation was observed between the levels of β-TG and SFMC.There were negative correlations between the levels of serum albumin and β-TG, and between the serum albumin and SFMC.The concentrations of plasma fibrinogen, α₂-globulin, and urea nitrogen were correlated to β-TG and SFMC.
It is concluded that the hypoalbuminemia concerned in such fibrinocoagulopathy was indicated by a platelet release reaction and fibrin derivative production, and might be involved in the development of diabetic microangiopathy.