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Kidney Week

Abstract: TH-PO583

Edema and the Risk of Thromboembolic Complications in Nephrotic Syndrome: A Cohort Study

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Kelddal, Sarah, Aarhus Universitetshospital Afdeling Nyresygdomme, Aarhus, Denmark
  • Tofig, Bawer Jalal, Regionshospitalet Godstrup Afdeling Hjertesygdomme, Herning, Denmark
  • Grove, Erik Lerkevang, Aarhus Universitetshospital Afdeling Hjertesygdomme, Aarhus, Denmark
  • Hvas, Anne-Mette, Aarhus Universitet Faculty of Health, Aarhus, Denmark
  • Christiansen, Christian Fynbo, Aarhus University Hospital Department of Clinical Epidemiology, Aarhus, Denmark
  • Birn, Henrik, Aarhus Universitetshospital Afdeling Nyresygdomme, Aarhus, Denmark
Background

Nephrotic syndrome (NS) is defined by severe albuminuria, hypoalbuminemia, and edema; however, the prevalence of edema with nephrotic range albuminuria and the associated risk of complications is unclear. We examined edema prevalence and the association between edema, mortality, and thromboembolic events (TE) in a cohort of NS patients.

Methods

A cohort study including patients being hospitalized or treated in outpatient clinics with a urine albumin-creatinine ratio (uACR) > 2,200 mg/g and plasma-albumin < 30 g/L in the Central Denmark Region between 2015-2022. Patients were identified from the central laboratory database by screening all recorded uACR and p-albumin measurements. We further collected demographics and outcomes and reviewed all medical records to examine if edema was present at time of NS diagnosis. Patients were followed until death or end of study.

Results

Among 806 included patients with nephrotic range albuminuria, 459 (61.4%) had edema at time of diagnosis. A total of 34 (4.2%) arterial TE (ATE) and 23 (2.6%) venous TE (VTE) were observed during follow-up (Table 1). Patients with edema had a lower incidence rate of ATE compared to those without edema (10 vs 28 per 1000 person-years), while the incidence rate of VTE did not differ between groups. All-cause one-year mortality was higher in the edema group (33.7% vs 25.7%).

Conclusion

Edema was prevalent at the time of diagnosis and was associated with an increased all-cause one-year mortality despite lower risk of ATE. Additional analyses are needed to explore this association and to determine the prognostic relevance of edema in the diagnosis of NS.

Funding

  • Private Foundation Support