Kidney Week

Abstract: FR-PO0676

Patients with Nephrotic Syndrome Who Develop Venous Thromboembolism Have More Significant Long-Term Kidney Function Decline: A Multicenter Retrospective Cohort Study

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Liu, Xin, Beijing Hospital, Beijing, China

Xin Liu, MD, PhD

• Wang, Dingyi, China-Japan Friendship Hospital, Beijing, China

Dingyi Wang, MD

Background

Venous thromboembolism (VTE) is a common complication of nephrotic syndrome (NS). While hypercoagulability has been considered the predominate mechanism, recent studies suggest that endothelial injury may also contribute to the high thrombotic risk. No study has focused on the association between VTE events and long-term renal outcomes in NS patients.

Methods

This retrospective cohort study included adult patients with newly diagnosed NS and a follow-up of >2 years at two tertiary hospitals in China between 2016 and 2022. VTE events were confirmed by ultrasound or CT angiography. Trajectories of eGFR over 3 years after NS diagnosis were plotted for VTE and non-VTE groups, and the slopes of eGFR decline were compared. A linear mixed-effects model (LMM) was used to assess the association between VTE and eGFR trajectories.

Results

A total of 198 patients were included, with an average follow-up time of 1297.5 ± 478.7 days. Renal biopsy was performed in 182 patients, of whom 110 (60.4%) had membranous nephropathy (MN). VTE occurred in 45 patients (22.7%). The mean age of the enrolled patients was 49.9 ± 15.1 years, and 64.6% were male. Three-year eGFR trajectory analysis showed that the VTE group had a significantly lower mean eGFR (p=0.045) and a steeper decline (β=-0.277 vs. β=-0.004, p=0.012) compared with the non-VTE group. After adjusting for age, sex, and baseline Scr, each additional year of follow-up was associated with an additional eGFR decline of 3.91 mL/min/1.73m² in the VTE group relative to the non-VTE group (p=0.018). In the MN subgroup, patients with VTE showed a faster eGFR decline (β=-5.89 mL/min/1.73m²/year, p=0.024), and prophylactic anticoagulation was significantly associated with better eGFR preservation in MN subgroup (β=11.59, p=0.024).

Conclusion

NS patients who develop VTE experienced more significant eGFR decline than those without VTE during long-term follow-up, particularly in the MN subgroup. These findings suggest an association between VTE and adverse renal outcomes in NS, providing evidence for improved intervention strategies in this population.

Funding

• Government Support – Non-U.S.