Antithrombin III and fibrinogen degradation product (fragment E) in diabetic nephropathy.

Plasma antithrombin III (AtIII), serum fragment E (FgE) and urine AtIII and FgE were measured in 25 diabetic patients with proteinuria above 1 g per day and compared to that in 25 patients with non-diabetic nephropathy, matched for the degree of proteinuria. Plasma AtIII concentrations were normal in both groups but FgE concentrations were increased. The level of plasma AtIII was directly related to HbA1 concentrations in the diabetics. For the same degree of proteinuria, the diabetic patients lost more AtIII and FgE in the urine. Urine AtIII was found to be mostly bound to activated procoagulants. Both urine AtIII and urine FgE correlated inversely with creatinine clearance. It was concluded that intraglomerular thrombosis probably contributes to the deteriorating renal function in diabetic nephropathy and is reflected in the concentrations of urine AtIII and FgE.