Venous thromboembolism in patients with membranous nephropathy

Sophia Lionaki, 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

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115 Scopus citations

Abstract

Background and objectives The aims of this study were to determine the frequency of venous thromboembolicevents 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.

Original languageEnglish (US)
Pages (from-to)43-51
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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