Proportionate increase of fibrinogen and albumin synthesis in nephrotic patients: Measurements with stable isotopes

Monique G M De Sain-Van Der Velden, George A. Kaysen, Kees De Meer, Frans Stellaard, Hieronymus A M Voorbij, Dirk Jan Reijngoud, Ton J. Rabelink, Hein A. Koomans

Research output: Contribution to journalArticle

82 Scopus citations

Abstract

Hyperfibrinogenemia is a common feature of the nephrotic syndrome, and contributes to increased tendency for thrombosis and atherosclerosis. Its genesis is not certain, but the increase in liver fibrinogen mRNA in nephrotic rats indicates increased synthesis. Data in humans are scarce. We presently compared synthesis rates of fibrinogen and albumin in nephrotic adults (N = 7; plasma albumin 22.3 ± 0.7 g/liter, proteinuria 12 g/day) and healthy control subjects (N = 8) using a primed/continuous infusion of the stable isotope L-[1-13C]valine for six hours. Absolute synthesis rate (ASR) of fibrinogen was 31 ± 3 mg/kg/day in nephrotic subjects and 21 ± 1 mg/kg/day in control subjects (P < 0.05), and positively correlated with plasma fibrinogen (P = 0.0317). The plasma fibrinogen pool was disproportionately increased in the nephrotic patients (271 ± 30 mg/kg) compared to the controls (126 ± 8 mg/kg), suggesting decreased fractional catabolic rate as well. The ASR of albumin was increased from 71 ± 4 mg/kg/day in the controls to 160 ± 19 mg/kg/day in the patients (P < 0.0001), and strongly correlated with the ASR of fibrinogen (P = 0.0046). Plasma α2-macroglobulin was also elevated and correlated with the albumin synthesis rate, whereas plasma serum amyloid A and C-reactive protein were not elevated. These data suggest that in nephrotic patients the increased albumin synthesis is associated with an increase in synthesis of a specific and coordinated group of proteins, among which is fibrinogen.

Original languageEnglish (US)
Pages (from-to)181-188
Number of pages8
JournalKidney International
Volume53
Issue number1
DOIs
StatePublished - 1998

Keywords

  • Albumin
  • Fibrinogen
  • Isotope measurement
  • Nephrotic syndrome

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Proportionate increase of fibrinogen and albumin synthesis in nephrotic patients: Measurements with stable isotopes'. Together they form a unique fingerprint.

  • Cite this

    De Sain-Van Der Velden, M. G. M., Kaysen, G. A., De Meer, K., Stellaard, F., Voorbij, H. A. M., Reijngoud, D. J., Rabelink, T. J., & Koomans, H. A. (1998). Proportionate increase of fibrinogen and albumin synthesis in nephrotic patients: Measurements with stable isotopes. Kidney International, 53(1), 181-188. https://doi.org/10.1046/j.1523-1755.1998.00729.x