Abstract
To the Editor.— Nephrotic patients with membranous glomerulonephritis have a very high incidence of renal vein thrombosis, as high as 40%. 1 The patient reported by Luft et al (234: 1158,1975) had this type of renal disease, and he also had another important predisposing factor for the development thrombosis—his extreme obesity. Obese patients have a deficient fibrinolytic mechanism 2,3 that correlates with the degree of overweight. 4 Obesity has recently been described in association with large amounts of fibrin in the glomeruli, mesangial IgM, C3, and a form of nephrotic syndrome that is reversible with weight reduction. 5 It is conceivable that fibrin deposition in the glomeruli could limit the phagocytic action of the mesangial cells reducing their efficiency in the removal of immunocomplexes and other mediators of glomerular injury. I share the view that nephrotic patients with massive obesity, as well as those with membranous glomerulonephritis, should be carefully
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