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Updated: May 31, 2026

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Published on: February 10, 2023
Evaluating proteinuria and nephrotic syndrome in patients with venous thromboembolism
Naing Htike1, Keith Superdock1, Geoffrey Teehan1
1Department of Nephrology, Lankenau Medical Center, Wynnewood, Pennsylvania.
Introduction:
Venous thromboembolism (VTE) is a well-known complication of nephrotic syndrome (NS). Proteinuria, a marker of chronic kidney disease, discovered at the time of VTE, may be the first presentation in patients with occult chronic kidney disease and/or NS.
Methods:
Electronic medical records at a community teaching hospital were retrospectively reviewed to measure the percentage of patients with acute VTE who had a urinalysis (UA) and/or an evaluation of 24-hour urine protein collection or urine protein to creatinine ratio. Thromboembolic events were defined as acute deep vein thrombosis and/or pulmonary embolism. NS was defined as ≥3.5 g proteinuria in 24 hours or by urine protein to creatinine ratio exceeding 3.5.
Results:
UA was done in 198 patients (63%) on the same admission for VTE and in 83 patients (26%) at a later date. Proteinuria, on routine UA, was identified in 154 (54%) patients. However, only 29 of 154 patients (19%) with proteinuria on UA had a formal evaluation of urine protein excretion, either by 24-hour collection or by spot protein to creatinine ratio. Eight of these 29 patients (28%) had NS.
Conclusions:
Patients suffering from VTE may have proteinuria if not frank NS. The UA should be part of the routine evaluation of a patient with VTE given the unexpectedly high prevalence of proteinuria and even NS in this cohort.
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