Relationship between proteinuria and venous thromboembolism

Kato, Shu Mei; Chernyavsky, Svetlana; Tokita, Joji; Shimada, Yuichi J.; Homel, Peter; Rosen, Herman; Winchester, James F.

doi:10.1007/s11239-010-0442-z

Cited by 33 publications

(23 citation statements)

References 26 publications

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“…Similar to our finding, the Midwest Pediatric Nephrology Consortium Study (MWPNC study), found proteinuria ( p < 0.0001) as a significant independent risk factor of TE in children with nephrotic syndrome [23]. The possible link between microalbuminuria or proteinuria and the risk of thromboembolic events have also been demonstrated in the general population, in patients with atrial fibrillation and in a cohort of hospitalized patients with nephrotic syndrome who underwent imaging study for TE [22,24-26]. …”

Section: Discussionsupporting

confidence: 83%

Proteinuria and hypoalbuminemia are risk factors for thromboembolic events in patients with idiopathic membranous nephropathy: an observational study

et al. 2012

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BackgroundPatients with nephrotic syndrome are at an increased risk of thromboembolic events (TEs). However, this association has not been thoroughly investigated in adult patients with idiopathic membranous nephropathy (IMN).MethodsA retrospective analysis of all 101 consecutive adult patients with MN diagnosed at our centre during 1995 to 2008 was performed. Pertinent data including thromboembolic events and the risk factors for TEs were recorded.ResultsThe cohort was followed for 7.2 ± 3 years. Out of 78 patients with IMN, 15 (19.2%) had at least one TE. No TEs occurred six months after diagnosis. The incidence of TEs in the first 6 months of diagnosis was 7.69% (95%CI, 2.5-17.0) and all patients except one had venous TEs. At the time of diagnosis of MN, the patients with TEs had lower serum albumin (1.9 ± 0.5 vs. 2.4 ± 0.4 g/dl, TE vs. no TE; p < 0.01) and greater serum cholesterol (414 ± 124 vs. 317 ± 108 mg/dl, TE vs. no TE; p = 0.01) and 24-h proteinuria (10.7 ± 3 vs. 7.1 ± 4 g, TE vs. no TE; p < 0.01). Multivariate logistic regression adjusted for age, sex, cholesterol and creatinine revealed, an odds ratio of 0.8 (95% CI 0.7 – 0.96; p = 0.01) for every one g/dl increase in baseline serum albumin and, an odds ratio of 1.3 (95% CI 1.05-1.58; p = 0.01) for one gram increase in 24-h proteinuria, for TEs.ConclusionsOur study finding confirms IMN as a prothrombotic state particularly in the first six months of diagnosis. Proteinuria, in addition to hypoalbuminemia, is a risk factor for TEs. These results have important implications for clinical care of patients with IMN, particularly with regards to initiation and duration of prophylactic anticoagulation.

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Section: Discussionsupporting

confidence: 83%

Proteinuria and hypoalbuminemia are risk factors for thromboembolic events in patients with idiopathic membranous nephropathy: an observational study

et al. 2012

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“…Mahmoodi et al [11] showed that proteinuria and serum albumin levels tended to be related to VTE. Another study demonstrated that, compared with those who did not have proteinuria, patients who tested positive for proteinuria had a 3.4-fold increased risk of VTE [15]. However, in this study, proteinuria and serum albumin were not risk factors for the development of VTE in FSGS.…”

Section: Discussioncontrasting

confidence: 74%

Risk factors of venous thromboembolism in focal segmental glomerulosclerosis with nephrotic syndrome

Zhou

et al. 2015

Clin Exp Nephrol

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“…It would be useful to explore whether proteinuria in combination with decreased kidney function is associated with a more increased risk of venous thrombosis than decreased kidney function alone. Proteinuria, especially in the nephrotic range, has been associated with venous thrombosis [22][23][24]. Another limitation was that arterial thrombosis was self-reported.…”

Section: Discussionmentioning

confidence: 99%

Risk of venous thrombosis in patients with chronic kidney disease: identification of high-risk groups

Ocak

Lijfering

Verduijn

et al. 2013

Journal of Thrombosis and Haemostasis

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Summary Background Although an association between venous thrombosis and chronic kidney disease has recently been established, it is unknown which patients with chronic kidney disease are most likely to benefit from thromboprophylaxis. Objective The aim of this study was to assess the association between venous thrombosis and chronic kidney disease in combination with arterial thrombosis, malignancy, surgery and thrombophilia to identify high‐risk groups as a basis for personalized prevention. Methods This study included 2473 consecutive patients with first venous thrombosis and 2936 controls from a case–control study (the MEGA study). Results Moderately decreased kidney function (eGFR 30–60 mL min−1) was associated with a 2.5‐fold (95% CI, 1.9–3.4) increased risk and severely decreased kidney function (eGFR < 30 mL min−1) was associated with a 5.5‐fold (95% CI 1.8–16.7) increased risk of venous thrombosis, compared with those with normal kidney function (eGFR > 90 mL min−1). The risk of venous thrombosis was additionally increased for moderately and severely reduced kidney function in combination with arterial thrombosis (odds ratio, 4.9; 95% CI, 2.2–10.9), malignancy (5.8; 95% CI, 2.8–12.1), surgery (14.0; 95%, CI 5.0–39.4), immobilization (17.1; 95% CI, 6.8–43.0) or thrombophilia (odds ratios, 4.3–9.5), with particularly high risks when three or more risk factors were present (odds ratio, 56.3; 95% CI, 7.6–419.3). Conclusion Decreased kidney function is associated with an increased risk of venous thrombosis. The risk increased substantially in the presence of one or more other risk factors for thrombosis.

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Relationship between proteinuria and venous thromboembolism

Cited by 33 publications

References 26 publications

Proteinuria and hypoalbuminemia are risk factors for thromboembolic events in patients with idiopathic membranous nephropathy: an observational study

Proteinuria and hypoalbuminemia are risk factors for thromboembolic events in patients with idiopathic membranous nephropathy: an observational study

Risk factors of venous thromboembolism in focal segmental glomerulosclerosis with nephrotic syndrome

Risk of venous thrombosis in patients with chronic kidney disease: identification of high-risk groups

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