Abstract
Background and objectives. Venous thromboembolic events (VTEs) are among the most important complications of nephrotic syndrome (NS). We conducted a study that aimed to determine the prevalence of inherited risk factors for VTE in NS and to identify which factors are independent predictors of VTE. Materials and Methods. Thirty-six consecutive patients with primary NS that underwent percutaneous kidney biopsy between January 2017 and December 2017 were enrolled in this retrospective, observational study. VTEs were the primary outcome. Baseline demographic and biochemical data were collected from medical records, and genetic testing was done for polymorphisms of Factor V, PAI, MTHFR, and prothrombin genes. Results. The incidence of VTE was 28%, and the median time to event was 3 months (IQR: 2–9). The prevalence of inherited risk factors was 14% for Factor V Leiden mutation, 5.6% for prothrombin G20210A, 44.5% for PAI, and 27.8% for each of the two polymorphisms of the MTHFR gene. On multivariate analysis, the presence of at least two mutations was independently associated with the risk of VTE (HR, 8.92; 95% confidence interval, CI: 1.001 to 79.58, p = 0,05). Conclusions. These findings suggest that genetic testing for inherited thrombophilia in NS could play an important role in detecting high-risk patients that warrant prophylactic anticoagulation.
Highlights
Venous thromboembolic events (VTEs) are serious complications of nephrotic syndrome (NS), associated with significant morbidity and mortality [1]
Four patients were excluded from the study due to the absence of histopathological diagnosis or identification of a secondary cause for the nephrotic syndrome
Was the most common type of glomerulopathy found on kidney biopsy (38.9%), followed by IgA
Summary
Venous thromboembolic events (VTEs) are serious complications of nephrotic syndrome (NS), associated with significant morbidity and mortality [1]. The reported incidence varies widely (5–50%), due primarily to the retrospective nature of most studies and the lack of an accurate screening method that eludes an important number of asymptomatic cases [1,2,3,4]. VTEs must be viewed as a multifactorial disorder with the underlying pathogenesis being a complex interplay of inherited and acquired risk factors [6]. Venous thromboembolic events (VTEs) are among the most important complications of nephrotic syndrome (NS). We conducted a study that aimed to determine the prevalence of inherited risk factors for VTE in NS and to identify which factors are independent predictors of VTE. The prevalence of inherited risk factors was
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