title: Venous thromboembolism in patients with membranous nephropathy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Laiko Hospital, Athens, Greece. sofia_lionaki@med.unc.edu
authors.forename: Sophia
authors.initials: S
authors.lastname: Lionaki
authors.forename: Vimal K
authors.initials: VK
authors.lastname: Derebail
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hogan
authors.forename: Sean
authors.initials: S
authors.lastname: Barbour
authors.forename: Taewoo
authors.initials: T
authors.lastname: Lee
authors.forename: Michelle
authors.initials: M
authors.lastname: Hladunewich
authors.forename: Allen
authors.initials: A
authors.lastname: Greenwald
authors.forename: Yichun
authors.initials: Y
authors.lastname: Hu
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Jennette
authors.forename: J Charles
authors.initials: JC
authors.lastname: Jennette
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Falk
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Cattran
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Nachman
authors.forename: Heather N
authors.initials: HN
authors.lastname: Reich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015433:Glomerulonephritis, Membranous / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D013997:Time Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology*
chemical_list: D012709:Serum Albumin
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