Risk factors of pulmonary thrombosis/embolism in nephrotic syndrome

Nephrotic syndrome is associated with an increased risk for thromboembolic complications. Until now, few studies have ever specified the risk of pulmonary thrombosis/embolism (PTE) in patients with nephrotic syndrome. In this study, we assessed the risk of PTE in a large cross-sectional study to identify risk factors in this population.

Three hundred twelve patients with NS who had screened PTE through lung ventilation-perfusion scan were collected and analyzed. Multivariate Logistic regression was used to detect the independent risk factors for PTE. Logistic regression was used to identify the threshold value of D-dimer.

Sixty-five patients (20.8%) had PTE in individuals with NS. Elevated level of plasma D-dimer was identified as an independent risk factor of PTE on multivariate analysis (odds ratio = 1.54; 95% confidence interval: 1.27-1.88). While proteinuria at presentation and serum albumin were not associated with PTE after adjusted for D-dimer (P > 0.05). The cumulative probability of PTE was in a nearly linear association with the plasma D-dimer level even within the normal range. Based on the plasma D-dimer level, we had developed a concise model to predict the risk of pulmonary embolism using logistic curve.

In adult patients with NS, high level of plasma D-dimer was closely associated with PTE, whereas proteinuria or serum albumin level was not in this study. Using plasma D-dimer level, we developed a concise model to predict the risk of PTE.