Disease-specific risk of venous thromboembolic events is increased in idiopathic glomerulonephritis

Sean J. Barbour; Allen Greenwald; Ognjenka Djurdjev; Adeera Levin; Michelle A. Hladunewich; Patrick H. Nachman; Susan L. Hogan; Daniel C. Cattran; Heather N. Reich

doi:10.1038/ki.2011.312

Disease-specific risk of venous thromboembolic events is increased in idiopathic glomerulonephritis

Sean J. Barbour, Allen Greenwald, Ognjenka Djurdjev, Adeera Levin, Michelle A. Hladunewich, Patrick H. Nachman, Susan L. Hogan, Daniel C. Cattran, Heather N. Reich

Research output: Contribution to journal › Article › peer-review

155 Scopus citations

Abstract

The risk of venous thromboembolic events is thought to be highest in patients with membranous nephropathy. This association has been recently questioned, and it is not known whether this simply reflects the severity of proteinuria. To better understand the relationship between histologic diagnosis and the risk of venous thromboembolic events we evaluated patients in the Toronto Glomerulonephritis Registry. Of 1313 patients with idiopathic glomerulonephritis, 395 were diagnosed with membranous nephropathy, 370 with focal segmental glomerulosclerosis (FSGS), and 548 with immunoglobulin-A nephropathy (IgAN). Risk factors were evaluated by Cox proportional hazards for 53 image-confirmed venous thromboembolic events in 44 patients during a median follow-up of 63 months. The risk was highest in patients with membranous nephropathy and FSGS (hazard ratios of 22 and 7.8, respectively) referenced to patients with IgAN. Following adjustment for gender, cancer history, proteinuria, and serum albumin by multivariable analysis, the histologic subtype remained an independent risk for venous thromboembolic events. This risk was still highest in patients with membranous nephropathy followed by FSGS with adjusted hazard ratios of 10.8 and 5.9, respectively. Thus, in this large cohort, histologic diagnosis was an independent risk factor for venous thromboembolic events. Further studies are needed to discover mechanisms responsible for this high risk in patients with membranous nephropathy.

Original language	English (US)
Pages (from-to)	190-195
Number of pages	6
Journal	Kidney international
Volume	81
Issue number	2
DOIs	https://doi.org/10.1038/ki.2011.312
State	Published - Jan 2 2012
Externally published	Yes

Bibliographical note

Funding Information:
We are grateful for the support of the nephrologists of the Greater Toronto Area for their ongoing participation in the Toronto Glomerulonephritis Registry. We thank registrars Naomi Ryan and Paul Ling for their diligent contributions to maintaining and updating the Registry data. HNR's work is supported by a KRESCENT New Investigator award, courtesy of the Kidney Foundation of Canada, the Canadian Society of Nephrology, and the Canadian Institute of Health Research. SJB is supported by the Clinician Investigator Program of the University of British Columbia, and the BC Renal Agency.

Keywords

glomerulonephritis
membranous nephropathy
nephrotic syndrome
thrombosis

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Disease-specific risk of venous thromboembolic events is increased in idiopathic glomerulonephritis",

abstract = "The risk of venous thromboembolic events is thought to be highest in patients with membranous nephropathy. This association has been recently questioned, and it is not known whether this simply reflects the severity of proteinuria. To better understand the relationship between histologic diagnosis and the risk of venous thromboembolic events we evaluated patients in the Toronto Glomerulonephritis Registry. Of 1313 patients with idiopathic glomerulonephritis, 395 were diagnosed with membranous nephropathy, 370 with focal segmental glomerulosclerosis (FSGS), and 548 with immunoglobulin-A nephropathy (IgAN). Risk factors were evaluated by Cox proportional hazards for 53 image-confirmed venous thromboembolic events in 44 patients during a median follow-up of 63 months. The risk was highest in patients with membranous nephropathy and FSGS (hazard ratios of 22 and 7.8, respectively) referenced to patients with IgAN. Following adjustment for gender, cancer history, proteinuria, and serum albumin by multivariable analysis, the histologic subtype remained an independent risk for venous thromboembolic events. This risk was still highest in patients with membranous nephropathy followed by FSGS with adjusted hazard ratios of 10.8 and 5.9, respectively. Thus, in this large cohort, histologic diagnosis was an independent risk factor for venous thromboembolic events. Further studies are needed to discover mechanisms responsible for this high risk in patients with membranous nephropathy.",

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author = "Barbour, {Sean J.} and Allen Greenwald and Ognjenka Djurdjev and Adeera Levin and Hladunewich, {Michelle A.} and Nachman, {Patrick H.} and Hogan, {Susan L.} and Cattran, {Daniel C.} and Reich, {Heather N.}",

note = "Funding Information: We are grateful for the support of the nephrologists of the Greater Toronto Area for their ongoing participation in the Toronto Glomerulonephritis Registry. We thank registrars Naomi Ryan and Paul Ling for their diligent contributions to maintaining and updating the Registry data. HNR's work is supported by a KRESCENT New Investigator award, courtesy of the Kidney Foundation of Canada, the Canadian Society of Nephrology, and the Canadian Institute of Health Research. SJB is supported by the Clinician Investigator Program of the University of British Columbia, and the BC Renal Agency. ",

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N2 - The risk of venous thromboembolic events is thought to be highest in patients with membranous nephropathy. This association has been recently questioned, and it is not known whether this simply reflects the severity of proteinuria. To better understand the relationship between histologic diagnosis and the risk of venous thromboembolic events we evaluated patients in the Toronto Glomerulonephritis Registry. Of 1313 patients with idiopathic glomerulonephritis, 395 were diagnosed with membranous nephropathy, 370 with focal segmental glomerulosclerosis (FSGS), and 548 with immunoglobulin-A nephropathy (IgAN). Risk factors were evaluated by Cox proportional hazards for 53 image-confirmed venous thromboembolic events in 44 patients during a median follow-up of 63 months. The risk was highest in patients with membranous nephropathy and FSGS (hazard ratios of 22 and 7.8, respectively) referenced to patients with IgAN. Following adjustment for gender, cancer history, proteinuria, and serum albumin by multivariable analysis, the histologic subtype remained an independent risk for venous thromboembolic events. This risk was still highest in patients with membranous nephropathy followed by FSGS with adjusted hazard ratios of 10.8 and 5.9, respectively. Thus, in this large cohort, histologic diagnosis was an independent risk factor for venous thromboembolic events. Further studies are needed to discover mechanisms responsible for this high risk in patients with membranous nephropathy.

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Disease-specific risk of venous thromboembolic events is increased in idiopathic glomerulonephritis

Abstract

Bibliographical note

Keywords

UN SDGs

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