Abstract: TH-PO633
Characteristics of Membranous Nephropathy Patients Presenting with an Arterial or Venous Thromboembolism: A Retrospective Cohort Study
Session Information
- Glomerular Diseases: Clinical and Epidemiologic Studies
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Visch, Ruben, Radboudumc, Nijmegen, Gelderland, Netherlands
- Wetzels, Jack F., Radboudumc, Nijmegen, Gelderland, Netherlands
- van de Logt, Anne-Els, Radboudumc, Nijmegen, Gelderland, Netherlands
Background
Membranous nephropathy (MN) is associated with a very high risk for developing arterial (ATE) or venous (VTE) thromboembolism. A previous study suggested an association between high PLA2Rab titers and ATE/VTE risk. We aimed at comparing MN patients with ATE/VTE at presentation versus MN patients without.
Methods
A total of 508 incident nephrotic MN patients were enrolled in this study. Nephrotic patients with ATE/VTE from six months prior and up to two weeks after the diagnosis of MN were defined as cases. Controls were MN patients without ATE/VTE. Differences in baseline data and outcome were studied.
Results
Twenty-five patients (5%) with ATE (n=6) or VTE (n=19) at presentation were compared to 483 patients without ATE/VTE. Baseline characteristics are presented in table 1. Approximately 75% of patients were PLA2Rab positive. There were no differences in PLA2Rab titer nor in severity of nephrotic syndrome between patients with or without ATE/VTE (Table). During follow-up (median 28.5 [11.7 – 66.4] months), 64% in the VTE/ATE group was treated with immunosuppressive therapy, compared to 58% in the control group (p = .713). Spontaneous remissions occurred in three patients in the ATE/VTE group.
Conclusion
We could not confirm the association between higher PLA2Rab levels and presentation with ATE/VTE. All patients were severely nephrotic, likely explaining the futility of serum albumin. Better biomarkers of thrombotic risk are needed.
Table 1. Baseline characteristics of the studied MN patients with and without an ATE or VTE at presentation
| Baseline characteristics | With ATE/VTE (n=25) | Without ATE/VTE (n=483) | p Value |
| Gender (male, n (%)) | 20 (80) | 336 (70) | 0.375 |
| Age (years) | 55 ± 13 | 55 ± 15 | 0.999 |
| PLA2R-related M (n, %) | 20 (80) | 358 (74) | 0.673 |
| sCreatinine (umol/l) | 102 [81-149] | 91 [77-113] | 0.263 |
| sAlbumine (g/L) | 18 [14-24] | 20 [16-24] | 0.187 |
| UPCR (g/10 mmol) | 8.0 [5.9-9.9] | 6.9 [5.0-10.3] | 0.269 |
| PLA2R-ab titer (RU/ml)* | 91 [50-153] | 87 [22-218] | 0.604 |
*aPLA2R titers at presentation were available for 16 and 360 patients in the cases and control groups respectively.