Risk of thromboembolic events in patients with nephrotic syndrome and relatively high albumin levels

Thromboembolic events are common in people with nephrotic syndrome (NS), particularly within the first 6 months following diagnosis. Low serum albumin level (<25 g/L) is considered to be an independent risk factor for venous thrombus embolism regardless of the degree of proteinuria, with the risk increasing proportionately with declining albumin level. 

Little is known, however, about the proportion and characteristics of people with relatively high albumin levels (≥25 g/L). The present study, therefore, explored the proportion of patients with relatively high albumin levels among those with NS and relevant thromboembolic events, and to assess the differences between this group and those with low albumin levels.

From 2012–2022, the study recruited 312 hospitalised patients in a centre in China who had diagnoses of NS and relevant thromboembolic events. Based on when their thromboembolic event occurred, 84 (26.9%) had relatively high albumin levels (≥25 g/L) and 228 (73.1%) had relatively low levels (<25 g/L). 

The two groups were similar with respect to clinical characteristics and coagulation parameters, except that the high-albumin group had significantly lower levels of 24-hour proteinuria (P<0.01) than the low-albumin group. The high-albumin group had a higher rate of autoimmune disease (P=0.03) than the low-albumin group. 

Membranous nephropathy (MN) was the most common pathological type of NS in patients with thromboembolic events in both groups. Anti-PLA2R-positive MN was significantly less common in the high-albumin group than in the low-albumin group (P<0.01).

The investigators concluded that there is still a high risk for patients with NS and relatively high albumin levels to develop thromboembolic events. 

The full article can be read here.