title: Evaluating proteinuria and nephrotic syndrome in patients with venous thromboembolism.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a well-known complication of nephrotic syndrome (NS). Proteinuria, a marker of chronic kidney disease, discovered at the time of VTE, may be the first presentation in patients with occult chronic kidney disease and/or NS.
  
  
  METHODS
  Electronic medical records at a community teaching hospital were retrospectively reviewed to measure the percentage of patients with acute VTE who had a urinalysis (UA) and/or an evaluation of 24-hour urine protein collection or urine protein to creatinine ratio. Thromboembolic events were defined as acute deep vein thrombosis and/or pulmonary embolism. NS was defined as ≥3.5 g proteinuria in 24 hours or by urine protein to creatinine ratio exceeding 3.5.
  
  
  RESULTS
  UA was done in 198 patients (63%) on the same admission for VTE and in 83 patients (26%) at a later date. Proteinuria, on routine UA, was identified in 154 (54%) patients. However, only 29 of 154 patients (19%) with proteinuria on UA had a formal evaluation of urine protein excretion, either by 24-hour collection or by spot protein to creatinine ratio. Eight of these 29 patients (28%) had NS.
  
  
  CONCLUSIONS
  Patients suffering from VTE may have proteinuria if not frank NS. The UA should be part of the routine evaluation of a patient with VTE given the unexpectedly high prevalence of proteinuria and even NS in this cohort.
authors.affiliation: Department of Nephrology, Lankenau Medical Center, Wynnewood, Pennsylvania. Electronic address: nhtike@aol.com.
authors.forename: Naing
authors.initials: N
authors.lastname: Htike
authors.affiliation: Department of Nephrology, Lankenau Medical Center, Wynnewood, Pennsylvania.
authors.forename: Keith
authors.initials: K
authors.lastname: Superdock
authors.affiliation: Department of Nephrology, Lankenau Medical Center, Wynnewood, Pennsylvania.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Teehan
authors.affiliation: Department of Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania.
authors.forename: Sampath
authors.initials: S
authors.lastname: Thiruveedi
authors.affiliation: Department of Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania.
authors.forename: William
authors.initials: W
authors.lastname: Surkis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014692:Ventilation-Perfusion Ratio
chemical_list: D003404:Creatinine