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Trombosis a pesar de proteinuria subnefrótica
Jose Redondo1, Alexander J Dobek1, Leonardo B Sosa1
1Internal Medicine, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, USA.
Cureus
|January 28, 2026
Resumen
Los pacientes con proteinuria subnefrótica y albúmina baja pueden enfrentar altos riesgos de coagulación, similares al síndrome nefrótico. Esto resalta la necesidad de un manejo cuidadoso del tromboembolismo venoso (TEV) en estas personas.
Área de la Ciencia:
- Nefrología
- Hematología
- Medicina Interna
Sus antecedentes:
- El síndrome nefrótico es un factor de riesgo conocido para el tromboembolismo venoso (TEV).
- La proteinuria subnefrótica y la hipoalbuminemia también son reconocidas cada vez más como contribuyentes a la hipercoagulabilidad.
- La comprensión del riesgo de coagulación en estas afecciones es crucial para el manejo del paciente.
Objetivo del estudio:
- Destacar la asociación entre la proteinuria subnefrótica, la hipoalbuminemia y un mayor riesgo de TEV.
- Presentar un caso que ilustra el potencial de desarrollo de TEV incluso cuando la anticoagulación se interrumpe temporalmente.
- Enfatizar la necesidad de un enfoque integral para el manejo del riesgo de TEV en pacientes con enfermedad renal.
Principales métodos:
- Informe de caso de un paciente de 40 años que presenta anasarca, disnea y trombosis venosa profunda (TVP).
- Observación clínica del desarrollo de TEV durante la interrupción temporal de la anticoagulación antes de una biopsia renal.
- Revisión de la presentación clínica y los hallazgos diagnósticos del paciente.
Principales resultados:
- El paciente presentó TVP bilaterales en extremidades inferiores y embolia pulmonar.
- Se desarrollaron nuevas TVP bilaterales en extremidades superiores tras la interrupción temporal de la anticoagulación.
- Se observó hipoalbuminemia en el contexto de proteinuria subnefrótica como un posible indicador de riesgo de coagulación.
Conclusiones:
- La proteinuria subnefrótica y la hipoalbuminemia justifican la consideración como factores de riesgo significativos para el TEV.
- Son esenciales estrategias de manejo cuidadosas para los pacientes con estas afecciones, particularmente cuando los procedimientos requieren la interrupción temporal de la anticoagulación.
- Se recomienda un enfoque multidisciplinario para optimizar la prevención y el tratamiento del TEV en esta población de pacientes.
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