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Abstract: TH-PO633

Characteristics of Membranous Nephropathy Patients Presenting with an Arterial or Venous Thromboembolism: A Retrospective Cohort Study

Session Information

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 characteristicsWith ATE/VTE (n=25)Without ATE/VTE (n=483)p Value
Gender (male, n (%))20 (80)336 (70)0.375
Age (years)55 ± 1355 ± 150.999
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.