title: Epidemiology and risk factors for thromboembolic complications of childhood nephrotic syndrome: a Midwest Pediatric Nephrology Consortium (MWPNC) study.
abstract: OBJECTIVE
  To identify clinical variables predictive of the risk of thromboembolism (TE), and to confirm the incidence of TE in primary and secondary childhood nephrotic syndrome (NS).
  
  
  METHODS
  A comprehensive chart review identified 326 children with NS from any cause evaluated between 1999 and 2006. These patients had a total of 1472.8 patient-years of follow-up. Comparison statistics, survival analysis, and logistic regression were used to define TE epidemiology and clinical risk factors.
  
  
  RESULTS
  We found that 9.2% of our cohort had experienced at least 1 TE. The overall incidence was 20.4 patients with TEs/1000 patient-years. The median time to the first TE was 70.5 days after diagnosis of NS. Deep venous thrombosis was the most common TE (76%) and was frequently associated with the use of a central venous catheter (45%). Significant independent predictors of TE included age > or = 12 years at onset of NS (P < .0001), severity of proteinuria (P < .0001), and history of TE preceding diagnosis of NS (P < .0001). Life- or limb-threatening TEs represented 23.7% of the events.
  
  
  CONCLUSIONS
  Children with NS should be carefully followed for TE, particularly those who are age 12 years or older, have severe proteinuria, or have a previous history of TE.
authors.affiliation: Department of Pediatrics, College of Medicine, Ohio State University, Columbus, OH, USA.
authors.forename: Bryce A
authors.initials: BA
authors.lastname: Kerlin
authors.forename: Neal B
authors.initials: NB
authors.lastname: Blatt
authors.forename: Beng
authors.initials: B
authors.lastname: Fuh
authors.forename: Shuang
authors.initials: S
authors.lastname: Zhao
authors.forename: Amy
authors.initials: A
authors.lastname: Lehman
authors.forename: Carol
authors.initials: C
authors.lastname: Blanchong
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
authors.forename: William E
authors.initials: WE
authors.lastname: Smoyer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008824:Michigan / Q000453:epidemiology; D015999:Multivariate Analysis; D009404:Nephrotic Syndrome / Q000453:epidemiology*; D009820:Ohio / Q000453:epidemiology; D011507:Proteinuria / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013923:Thromboembolism / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D003404:Creatinine