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Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease

Bryce A Kerlin1, Rose Ayoob, William E Smoyer

  • 1Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA. Bryce.Kerlin@NationwideChildrens.org

Clinical Journal of the American Society of Nephrology : CJASN
|February 21, 2012
PubMed

Insights

Thromboembolism is a serious complication of nephrotic syndrome, particularly in adults and older children. Management focuses on anticoagulation, with further research needed to identify high-risk groups and molecular targets.

Area of Science:

  • Nephrology
  • Hematology
  • Pediatrics

Background:

  • Thromboembolism is a significant life-threatening complication of nephrotic syndrome.
  • Understanding its epidemiology, pathophysiology, and management is crucial.

Purpose of the Study:

  • To review the epidemiology, clinical and molecular pathophysiology, and management of thromboembolism in nephrotic syndrome.

Main Methods:

  • Literature review summarizing existing studies on thromboembolism in nephrotic syndrome.
  • Analysis of epidemiological data, focusing on age and histological subtypes.
  • Examination of molecular hemostasis alterations and current therapeutic strategies.

Main Results:

  • Thromboembolism is more common in adults (26.7%) than children (2.8%), with higher risk in infants and children over 12.
  • Membranous nephropathy significantly increases risk in both adults (37.0%) and children (25%).
  • Pathological alterations involve antithrombin, fibrinogen, and factors V and VIII, but no clear molecular targets are identified.

Conclusions:

  • Inadequate evidence exists for routine prophylactic therapy.
  • Anticoagulation is the primary therapy, with thrombolysis for severe cases.
  • Future research should identify high-risk cohorts and molecular targets for prothrombotic pathophysiology.

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