ISSN 2997-1036
International Journal of Hematology | Vol. 14, No. 2, February 2023 | pp. 9–16
DOI: 10.46882/2023/IJH/000156
Original Article
Title: Evaluation of baseline plasma protein C activity as an independent predictor of macrovascular thromboembolic recurrence in active membranous nephropathy
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: Mass wasting of natural anticoagulant regulatory elements via glomerular membranes establishes a profound hypercoagulable state in membranous nephropathy, but the clinical utility of functional protein C tracking remains under-studied. This prospective study evaluated baseline plasma free protein C functional activity in 54 adult patients presenting with active membranous nephropathy to track its correlation with serum albumin depletion and 1-year thromboembolic outcomes. Protein C activity was quantified via chromogenic substrate assays prior to initiating standard immunosuppressive therapy. Severe protein C activity reduction (< 55.0%) was identified in 31.4% (17 of 54) of the nephrotic patients. Multivariable Cox proportional hazards regression revealed that baseline protein C activity below 55.0% was an independent predictor of acute deep vein thrombosis or pulmonary embolism within a 12-month follow-up window (hazard ratio = 3.84, P < 0.01). Protein C depression correlated inversely with serum albumin levels (r = -0.65, P < 0.001) and positively with D-dimer concentrations. Screening for functional protein C profiles provides clear prognostic utility, helping identify high-risk renal cohorts requiring early prophylactic anticoagulation.
Keywords: Membranous nephropathy, protein C activity, hypercoagulability, albuminuria, thromboembolism
Manuscript Timeline: Received: November 11, 2022; Revised: December 20, 2022; Accepted: January 10, 2023; Published: February 16, 2023