Studies on the Fibrinolytic Therapy in the Patients with Nephrotic Syndrome

Based on the concept that fibrinolytic therapy is applicable under disease conditions of a low fibrinolytic state, we performed measurements on the coagulo-fibrinolytic system in various renal diseases and obtained the following results. As the renal function decreased, the fibrinogen level rose, and the Euglobulin clot lysis time (hereinafter ELT) was prolonged. Compared to the case of chronic glomerulonephritis, a nephrotic syndrome (N.S.) showed a high fibrinogen level, ELT was prolonged, and antiplasmin was increased. Moreover, aminonucleoside nephrosis resulted, and in the acute stage there was a disease condition characterized by low fibrino-lytic activity in the hypercoagulability state. Considering fibrinolytic therapy to be suitable for mild renal failure and N.S., we administered the above patients urokinase (UK) for two weeks at a daily dosage of 60, 000 units. As a result of the administration of urokinase, there were no change in the urine protein and the renal function, but the fibrinogen and FDP levels decreased. Thus, the therapy was considered to be useful for recovery from N.S. Also, to investigate the fittingness of the dosage of UK 60, 000 units, we measured the coagulo-fibrinolytic system before and after administration, and it was found that the a2-plasmin inhibitor level was useful.