Abstract: SA-PO0782
Venous Thromboembolism Prophylaxis in Nephrotic Syndrome: Survey of Real-World Physician Practice
Session Information
- Glomerular Research: Design, Registries, Surveys, and Epidemiology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Gholizadeh Ghozloujeh, Zohreh, Loma Linda University Health, Loma Linda, California, United States
- Jhaveri, Kenar D., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
- Kronbichler, Andreas, Medizinische Universitat Innsbruck, Innsbruck, Tyrol, Austria
- Abdi Pour, Amir, Loma Linda University Health, Loma Linda, California, United States
- Ayehu, Gashu H., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
- Norouzi, Sayna, Loma Linda University Health, Loma Linda, California, United States
Background
Venous thromboembolism (VTE) is a recognized complication of nephrotic syndrome (NS), with 10-year incidence rates approaching 10%; yet, prophylactic strategies remain variable due to limited evidence guiding anticoagulant and antiplatelet use. We surveyed physicians to characterize real-world approaches to VTE prevention, including agent selection, aspirin use, and perceived thrombotic risk.
Methods
We conducted a cross-sectional, anonymous electronic survey of physicians involved in NS management. The 16-item questionnaire assessed anticoagulant and aspirin use, observed VTE rates, and NS caseload. Routine use was defined as anticoagulation for all NS patients; selective use referred to prescribing it based on risk factors. Respondents were stratified by NS volume (≤10 vs >10 patients/yr) and by years in practice (<10 yrs vs ≥10 yrs). Descriptive statistics and group comparisons (chi-square or Fisher’s exact tests) were performed using SPSS.
Results
A total of 176 physicians completed the survey, 93.8% of whom were nephrologists; 74.4% practiced in academic centers. Most (71.0%) reported managing more than 10 NS patients annually. Anticoagulation was recommended selectively by 77.8%, while 13.6% favored routine use. Direct oral anticoagulants were the most commonly preferred agents (36.9%), followed by low molecular weight heparin (28.4%) and warfarin (23.3%). Aspirin was used by 25.6% as a first-line in low-risk VTE and by 21.0% for anticoagulation intolerance; however, 48.9% did not use aspirin in NS. The majority (52.3%) reported observed VTE rates below 1%. Practice patterns did not differ by NS caseload. However, the anticoagulation strategy differed by years in practice (p = .011), with 20.5% of physicians practicing ≥10 years favoring routine use compared to 13.6% with <10 years.
Conclusion
The predominance of selective anticoagulation, frequent DOAC use, and limited aspirin adoption reflect evolving practice and persistent evidence gaps. Differences by experience highlight the need for studies and consensus to guide risk-aligned thromboprophylaxis in NS.
Practice Patterns by Years in Practice
| Years in Practice | Routine AC | Selective AC | No AC | DOAC Preferred | Aspirin First-Line |
| <10 years | 13.6% | 84.1% | 2.3% | 44.3% | 28.4% |
| ≥10 years | 13.6% | 71.6% | 14.8% | 29.5% | 22.7% |