title: Risk factors of venous thromboembolism in focal segmental glomerulosclerosis with nephrotic syndrome.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is an important and potentially life-threatening complication in focal segmental glomerulosclerosis (FSGS). The aim of this study was to investigate the prevalence and predisposing risk factors of venous thromboembolism in patients with FSGS with nephrotic syndrome.
  
  
  METHODS
  A total of 120 FSGS patients with nephrotic syndrome were enrolled in this study. Venous thromboembolism was confirmed by contrast-enhanced dual-source computed tomography angiography or magnetic resonance venography. Potential clinical and laboratory risk factors for VTE were screened.
  
  
  RESULTS
  Venous thrombosis was demonstrated in 12 (10 %) patients. Venous thrombosis occurred during the first episode of nephrotic syndrome in 3 patients and during a relapse in 9 patients. Eight patients had a pulmonary embolism, four had a renal vein thrombosis, three had a lower limb deep vein thrombosis, one had a cerebral sinovenous thrombosis, and one had a portal vein thrombosis. The positive predictive value for the D-dimer level was 22.4 % in the patients with FSGS, and the negative predictive value for the D-dimer level was 100 %. Of the screened risk factors, higher hematocrit and relapse of nephrotic syndrome were risk factors for VTE. Other risk factors, such as proteinuria, hypoalbuminemia, platelet count, fibrinogen level, and antithrombin III level, were not risk factors for VTE in patients with FSGS.
  
  
  CONCLUSIONS
  We found that the prevalence of venous thromboembolism is approximately 10 % in FSGS patients with nephrotic syndrome. Most of the patients had a PE. Hemoconcentration and relapse of nephrotic syndrome were risk factors for the development of VTE in FSGS. Negative D-dimer may exclude venous thromboembolism in patients with nephrotic syndrome.
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China. lisj8855@163.com.
authors.forename: Shi-jun
authors.initials: SJ
authors.lastname: Li
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China.
authors.forename: Yuan-Mao
authors.initials: YM
authors.lastname: Tu
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China.
authors.forename: Chang-sheng
authors.initials: CS
authors.lastname: Zhou
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Zhang
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China.
authors.forename: Zhi-hong
authors.initials: ZH
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications*; D015995:Prevalence; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Computed tomography angiography; Focal segmental glomerulosclerosis; Venous thromboembolism