Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;7(1):43-51.
doi: 10.2215/CJN.04250511. Epub 2011 Nov 10.

Venous thromboembolism in patients with membranous nephropathy

Sophia Lionaki  1 , Vimal K Derebail, Susan L Hogan, Sean Barbour, Taewoo Lee, Michelle Hladunewich, Allen Greenwald, Yichun Hu, Caroline E Jennette, J Charles Jennette, Ronald J Falk, Daniel C Cattran, Patrick H Nachman, Heather N Reich
Affiliations

Venous thromboembolism in patients with membranous nephropathy

Sophia Lionaki et al. Clin J Am Soc Nephrol. 2012 Jan.

Abstract

Background and objectives: The aims of this study were to determine the frequency of venous thromboembolic events in a large cohort of patients with idiopathic membranous nephropathy and to identify predisposing risk factors.

Design, setting, participants, & measurements: We studied patients with biopsy-proven membranous nephropathy from the Glomerular Disease Collaborative Network (n=412) and the Toronto Glomerulonephritis Registry (n=486) inception cohorts. The cohorts were pooled after establishing similar baseline characteristics (total n=898). Clinically apparent and radiologically confirmed venous thromboembolic events were identified. Potential risk factors were evaluated using multivariable logistic regression models.

Results: Sixty-five (7.2%) subjects had at least one venous thromboembolic event, and this rate did not differ significantly between registries. Most venous thromboembolic events occurred within 2 years of first clinical assessment (median time to VTE = 3.8 months). After adjusting for age, sex, proteinuria, and immunosuppressive therapy, hypoalbuminemia at diagnosis was the only independent predictor of a venous thromboembolic event. Each 1.0 g/dl reduction in serum albumin was associated with a 2.13-fold increased risk of VTE. An albumin level <2.8 g/dl was the threshold below which risk for a venous thromboembolic event was greatest.

Conclusions: We conclude that clinically apparent venous thromboembolic events occur in about 7% of patients with membranous nephropathy. Hypoalbuminemia, particularly <2.8 g/dl, is the most significant independent predictor of venous thrombotic risk.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Derivation of the membranous nephropathy (MN) cohort.
Figure 2.
Figure 2.
Distribution of venous thromboembolic event (VTE) during the observation time.
Figure 3.
Figure 3.
Renal survival probability among MN patients with and without VTE.
See this image and copyright information in PMC

Comment in

References

    1. Bellomo R, Atkins RC: Membranous nephropathy and thromboembolism: Is prophylactic anticoagulation warranted? Nephron 63: 249–254, 1993 - PubMed
    1. Llach F, Papper S, Massry SG: The clinical spectrum of renal vein thrombosis: Acute and chronic. Am J Med 69: 819–827, 1980 - PubMed
    1. Chugh KS, Malik N, Uberoi HS, Gupta VK, Aggarwal ML, Singhal PC, Suri S, Jain SK: Renal vein thrombosis in nephrotic syndrome—A prospective study and review. Postgrad Med J 57: 566–570, 1981 - PMC - PubMed
    1. Wagoner RD, Stanson AW, Holley KE, Winter CS: Renal vein thrombosis in idiopathic membranous glomerulopathy and nephrotic syndrome: Incidence and significance. Kidney Int 23: 368–374, 1983 - PubMed
    1. Velasquez Forero F, Garcia Prugue N, Ruiz Morales N: Idiopathic nephrotic syndrome of the adult with asymptomatic thrombosis of the renal vein. Am J Nephrol 8: 457–462, 1988 - PubMed

Publication types