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Risk factors of venous thromboembolism in focal segmental glomerulosclerosis with nephrotic syndrome

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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.

Conclusion

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.

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Acknowledgments

The authors acknowledge support from the National Natural Science Foundation of China (No. 81270799).

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Authors and Affiliations

  1. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People’s Republic of China

    Shi-jun Li, Yuan-Mao Tu, Li-Hua Zhang & Zhi-hong Liu

  2. Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People’s Republic of China

    Chang-sheng Zhou

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  1. Shi-jun Li
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  2. Yuan-Mao Tu
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  3. Chang-sheng Zhou
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  4. Li-Hua Zhang
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  5. Zhi-hong Liu
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Correspondence to Shi-jun Li.

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The authors declare that they have no other relevant financial interests.

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Li, Sj., Tu, YM., Zhou, Cs. et al. Risk factors of venous thromboembolism in focal segmental glomerulosclerosis with nephrotic syndrome. Clin Exp Nephrol 20, 212–217 (2016). https://doi.org/10.1007/s10157-015-1149-4

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  • DOI: https://doi.org/10.1007/s10157-015-1149-4

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