Hipercoagulabilidad en el síndrome nefrótico
Palabras clave:
trombofilia, síndrome nefrótico, anticoagulantes
Resumen
El síndrome nefrótico se describe clásicamente por la presencia de proteinuria, hipoalbuminemia, hiperlipidemia y edema. Los pacientes con síndrome nefrótico tienen un mayor riesgo de tromboembolismo, que se asocia con una morbilidad y mortalidad sustanciales. De acuerdo con la evidencia científica, se presenta tromboembolismo tanto en la circulación arterial como venosa. Sin embargo, es más frecuente encontrar casos de trombosis venosa profunda, embolia pulmonar y trombosis de la vena renal. Debido al estado de hipercoagulabilidad en el síndrome nefrótico, la tromboprofilaxis está tomando cada vez mayor importancia. El tratamiento debe ser individualizado, considerando las comorbilidades y el riesgo de sangrado en cada paciente. Existen diversos tratamientos en los que se incluye la warfarina, heparina, aspirina y anticoagulantes orales de acción directa. Estos últimos cada vez cobran mayor importancia debido a la seguridad cuando son administrados. Cuando el riesgo de hemorragia se considera bajo, se recomienda iniciar la anticoagulación profiláctica a dosis terapéuticas, siendo los anticoagulantes orales directos considerados como parte del tratamiento. La anticoagulación profiláctica en pacientes con síndrome nefrótico reduce el riesgo de eventos trombóticos tanto arteriales como venosos.
Citas
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2. Matyjek A, Rymarz A, Nowicka Z, Literacki S, Rozmyslowicz T, Niemczyk S. Anti-Xa activity of enoxaparin for prevention of venous thromboembolism in severe nephrotic syndrome—A single center prospective study. J Clin Med [Internet]. 2021 [cited 2025 Feb 14];10(23):5709. Available from: https://www.researchgate.net/publication/356844005_Anti-Xa_Activity_of_Enoxaparin_for_Prevention_of_Venous_Thromboembolism_in_Severe_Nephrotic_Syndrome-A_Single_Center_Prospective_Study
3. Abdelghani E, Waller AP, Wolfgang KJ, Stanek JR, Parikh SV, Rovin BH, Smoyer WE, Kerlin BA. Exploring the role of antithrombin in nephrotic syndrome-associated hypercoagulopathy: A multi-cohort study and meta-analysis. Clin J Am Soc Nephrol [Internet]. 2023 [cited 2025 Feb 14];18(2):234-44. Available from: https://pubmed.ncbi.nlm.nih.gov/36754010/
4. Greenberg KI, Choi MJ. Understanding hypercoagulability with nephrotic syndrome: How the clot thickens. Clin J Am Soc Nephrol [Internet]. 2023 [cited 2025 Feb 14];18(2):149-51. Available from: https://pubmed.ncbi.nlm.nih.gov/36754000/
5. Thummala AR, Morad T, Lees Ch, Cantor EE. Diagnostic challenges in nephrotic syndrome presenting with venous thromboembolism. Cureus [Internet]. 2024 [cited 2025 Feb 14]; 16(10): e71173. Available from: https://pubmed.ncbi.nlm.nih.gov/39525223/
6. Na SP, Ning ML, Ma JF, Liang S, Wang YL, Sui MS, et al. Association of elevated circulating monocyte-platelet aggregates with hypercoagulability in patients with nephrotic syndrome. Thromb J [Internet]. 2024 [cited 2025 Feb 14];22(1):56. Available from: https://pubmed.ncbi.nlm.nih.gov/38943162/
7. El-Bardissy A, Elshafei MN, Abdelgawad H, Mekkawi R, Eltahir A, Mohammed A, et al. Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study. Thromb J [Internet]. 2025 [cited 2025 Jul 10];23(1):9. Available from: https://pubmed.ncbi.nlm.nih.gov/39885575/
8. Parker K, Choudhuri S, Lewis P, Thachil J, Mitra S. UK prescribing practice of anticoagulants in patients with chronic kidney disease: a nephrology and haematology-based survey. BMC Nephrol [Internet]. 2023 [cited 2025 Feb 14] ;24(1):9. Available from: https://pubmed.ncbi.nlm.nih.gov/36635661/
9. Liu YM, Gao S, Liu LJ. The risk of thromboembolic events in patients with nephrotic syndrome and relatively high albumin levels: a study over 10 years. BMC Nephrol [Internet]. 2024 [cited 2025 Feb 14];25(1):301. Available from: https://pubmed.ncbi.nlm.nih.gov/39261806/
10.Tarragón B, Han H, Navarro-Torres M, Canetta P, Wooden B, Derebail VK, et al. Prophylactic anticoagulation in patients with nephrotic syndrome in the Cure Glomerulonephropathy (CureGN) cohort. Clin Kidney J [Internet]. 2025 [cited 2025 Oct 3];18(5):sfaf104. Available from: https://pubmed.ncbi.nlm.nih.gov/40357500/
11.Ponticelli C, Moroni G. Correction: Nephrotic syndrome: pathophysiology and consequences. J Nephrol [Internet]. 2025 [cited 2025 Feb 14];38(7):2025. Available from: https://pubmed.ncbi.nlm.nih.gov/40782184/
12.Cooley I, Derebail VK, Gibson KL, Álvarez C, Poulton CJ, Blazek LN, et al. Association of lupus nephritis histopathologic classification with venous thromboembolism—modification by age at biopsy. Kidney Int Rep [Internet]. 2021 [cited 2025 Feb 14];6(6):1653–60. Available from: https://pubmed.ncbi.nlm.nih.gov/34169206/
13.Van Meerhaeghe T, Cez A, Dahan K, Esteve E, Elalamy I, Boffa JJ, Ponlot E. Apixaban prophylactic anticoagulation in patients with nephrotic syndrome. TH Open [Internet]. 2022 [cited 2025 Feb 14];6(4):e299–303. Available from: https://pubmed.ncbi.nlm.nih.gov/36299618/
14.Frățilă VG, Lupușoru G, Sorohan BM, Obrișcă B, Mocanu V, Lupușoru M, Ismail G. Nephrotic syndrome: From pathophysiology to novel therapeutic approaches. Biomedicines [Internet]. 2024 [cited 2025 Feb 14];12(3): 569. Available from: https://doi.org/10.3390/biomedicines12030569
15.Han X, Zhao P, Wang Z, Ji X, Zhao M. Acute lower extremity arterial thrombosis associated with nephrotic syndrome in adults: case series and literature review. BMC Nephrol [Internet]. 2023 [cited 2025 Feb 14];24(1):318. Available from: https://pubmed.ncbi.nlm.nih.gov/37884862/
16.Gounden V, Vashisht R, Jialal I. Hipoalbuminemia. [Updated August, 28 2023]. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. [cited 2025 Feb 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526080/
17.Parker K, Ragy O, Hamilton P, Thachil J, Kanigicherla D. Thromboembolism in nephrotic syndrome: controversies and uncertainties. Res Pract Thromb Haemost [Internet]. 2023 [cited 2025 Feb 14];7(6):102162. Available from: https://pubmed.ncbi.nlm.nih.gov/37680313/
18.Sirvent AE, Urzola-Rodríguez G, Lorenzo A, Callejas-Martínez R, Saiz A, Calle-García L, et al. Arterial thrombosis in a patient with nephrotic syndrome and antithrombin Cambrigde II. Nefrología (Engl Ed) [Internet]. 2022 [cited 2025 Feb 14];42(6):729–31. Available from: https://www.revistanefrologia.com/es-arterial-thrombosis-in-patient-with-articulo-S2013251423000330
19.Verma PR, Patil P. Nephrotic syndrome: A review. Cureus [Internet]. 2024 [cited 2025 Feb 14]; 16(2): e53923. Available from: https://pubmed.ncbi.nlm.nih.gov/38465146/
20.Kelddal S, Hvas AM, Grove EL, Birn H. Safety and effectiveness of direct oral anticoagulants in patients with nephrotic syndrome: a report of 21 cases. BMC Nephrol [Internet]. 2022 [cited 2025 Feb 14];23(1):305. Available from: https://pubmed.ncbi.nlm.nih.gov/36064370/
21.Li J, Wang X, Jiang S, Li W. Serum PLA2R antibody as a predictive biomarker for venous thromboembolism risk in primary membranous nephropathy. Med Clin (Barc) [Internet]. 2023 [cited 2025 Feb 14];161(10):417–21. Available from: https://pubmed.ncbi.nlm.nih.gov/37532619/ Subscription required
22.Allison SP, Lobo DN. The clinical significance of hypoalbuminaemia. Clin Nutr [Internet]. 2024 [cited 2025 Feb 14];43(4):909–14. Available from: https://pubmed.ncbi.nlm.nih.gov/38394971/
23.Azarniouch DM, Crona DJ, Karnabi P, Bose B, Nachman PH, Carrier M, et al. Anticoagulation for the prevention of thrombotic events in nephrotic syndrome. Kidney Int Rep [Internet]. 2024 [cited 2025 Feb 14];9(10):3053–6. Available from: https://pubmed.ncbi.nlm.nih.gov/39430178/
24.Welander F, Holmberg H, Dimény E, Jansson U, Själander A. Prophylactic anticoagulants to prevent venous thromboembolism in patients with nephrotic syndrome—A retrospective observational study. PLoS One [Internet]. 2021 [cited 2025 Feb 14];16(7):e0255009. Available from: https://pubmed.ncbi.nlm.nih.gov/34319998/
25.Waller AP, Troost JP, Parikh SV, Wolfgang KJ, Rovin BH, Nieman MT, et al. Nephrotic syndrome disease activity is proportional to its associated hypercoagulopathy. Thromb Res [Internet]. 2021 [cited 2025 Feb 14];201:50–9. Available from: https://pubmed.ncbi.nlm.nih.gov/33636573/
26.Gholizadeh Ghozloujeh Z, Glassock RJ, Al Jurdi A, Jhaveri KD, Heidari-Bateni G, Bajpai D, et al. Venous thromboembolism prevention in nephrotic syndrome: The role of aspirin, vitamin K antagonists, and direct oral anticoagulants. Kidney Int Rep [Internet]. 2025 [cited 2025 Oct 10] ;10(5):1335–45. Available from: https://pubmed.ncbi.nlm.nih.gov/40485694/
27.Chi G, Lee JJ, Memar Montazerin S, Marszalek J. Association of D-dimer with short-term risk of venous thromboembolism in acutely ill medical patients: A systematic review and meta-analysis. Vasc Med [Internet]. 2022 [cited 2025 Feb 14];27(5):478–86. Available from: https://doi.org/10.1177/1358863x221109855
28.Rovin BH, Adler SG, Barratt J, Bridoux F, Burdge KA, Chan TM, et al. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int [Internet]. 2021 [cited 2025 Feb 14];100(4 Suppl):S1–276. Available from: https://pubmed.ncbi.nlm.nih.gov/34556256/
29.Cubilier E, Chergui Y, Garrouste C, Ramos I, Philipponnet C, Atenza A, et al. Nephrotic syndrome thromboprophylaxis with direct oral anticoagulants or vitamin K antagonists. Kidney Int Rep [Internet]. 2025 [cited 2025 Oct 10];10(5):1468–75. Available from: https://pubmed.ncbi.nlm.nih.gov/40485718/
30.Tian Y, Sun B, Sun G. Research progress of nephrotic syndrome accompanied by thromboembolism. Int Urol Nephrol [Internet]. 2023 [cited 2025 Feb 14];55(7):1735–45. Available from: https://pubmed.ncbi.nlm.nih.gov/36757656/ Subscription required
31.Zhu H, Xu L, Liu X, Liu B, Zhai Ch, Wang R, Yang X. Anti-PLA2R antibody measured by ELISA predicts the risk of vein thrombosis in patients with primary membranous nephropathy. Ren Fail [Internet]. 2022 [cited 2025 Feb 14];44(1):594–600. Available from: https://pubmed.ncbi.nlm.nih.gov/35380081/
32.Jeyalan V, Stauss M, Liew Kang S, Ponnusamy A. A retrospective analysis of venous thromboembolism incidence amongst patients with membranous nephropathy: A single centre experience. Is anti-PLA2R an accessory or an accomplice?. [Poster-469]. Kidney Int Rep [Internet]. 2022 [cited 2025 Feb 14];7(Suppl 2):S209. Available from: https://www.kireports.org/article/S2468-0249(22)00499-5/fulltext
33.Vestergaard SV, Birn H, Darvalics B, Nitsch D, Sørensen HT, Christiansen ChF. Risk of arterial thromboembolism, venous thromboembolism, and bleeding in patients with nephrotic syndrome: A population-based cohort study. Am J Med [Internet]. 2022 [cited 2025 Feb 14];135(5):615–25.e9. Available from: https://pubmed.ncbi.nlm.nih.gov/34979093/ Subscription required
34.McDonnell T, Hartemink J, Ragy O, Parker K, Shukkur M, Thachil J, Kanigicherla D. Longitudinal analysis of prophylactic anticoagulation in primary nephrotic syndrome: Low incidence of thromboembolic complications. Glomerular Dis [Internet]. 2023 [cited 2025 Feb 14];3(1):266–74. Available from: https://pubmed.ncbi.nlm.nih.gov/38054033/
35.Tijani A, Coons EM, Mizuki B, Dermady M, Stanilova K, Casey AL, et al. Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in patients with nephrotic syndrome: A retrospective cohort study. Ann Pharmacother [Internet]. 2023 [cited 2025 Feb 14];57(7):787–94. Available from: https://pubmed.ncbi.nlm.nih.gov/36214262/ Subscription required
36.Arches C, Jalal-Eddine A, Titeca-Beauport D, Dao M, Lobbedez T, Zaoui P, et al. Safety and efficacy of oral direct factor xa inhibitors in patients with nephrotic syndrome: Results from a national retrospective study. Kidney Int Rep [Internet]. 2025 [cited 2025 Oct 10];10(4):1188–95. Available from: https://pubmed.ncbi.nlm.nih.gov/40303208/
37.Meena P, Panda S, Garg A, Das P, Mylliemngap B, Kumari P. Evaluating the role of direct oral anticoagulants as a safer and effective option for thromboprophylaxis in nephrotic syndrome: A prospective observational study. [WCN25-1332]. Kidney Int Rep [Internet]. 2025 [cited 2025 Oct 10];10(2):S569. Available from: https://www.kireports.org/article/S2468-0249(24)03040-7/fulltext
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2. Matyjek A, Rymarz A, Nowicka Z, Literacki S, Rozmyslowicz T, Niemczyk S. Anti-Xa activity of enoxaparin for prevention of venous thromboembolism in severe nephrotic syndrome—A single center prospective study. J Clin Med [Internet]. 2021 [cited 2025 Feb 14];10(23):5709. Available from: https://www.researchgate.net/publication/356844005_Anti-Xa_Activity_of_Enoxaparin_for_Prevention_of_Venous_Thromboembolism_in_Severe_Nephrotic_Syndrome-A_Single_Center_Prospective_Study
3. Abdelghani E, Waller AP, Wolfgang KJ, Stanek JR, Parikh SV, Rovin BH, Smoyer WE, Kerlin BA. Exploring the role of antithrombin in nephrotic syndrome-associated hypercoagulopathy: A multi-cohort study and meta-analysis. Clin J Am Soc Nephrol [Internet]. 2023 [cited 2025 Feb 14];18(2):234-44. Available from: https://pubmed.ncbi.nlm.nih.gov/36754010/
4. Greenberg KI, Choi MJ. Understanding hypercoagulability with nephrotic syndrome: How the clot thickens. Clin J Am Soc Nephrol [Internet]. 2023 [cited 2025 Feb 14];18(2):149-51. Available from: https://pubmed.ncbi.nlm.nih.gov/36754000/
5. Thummala AR, Morad T, Lees Ch, Cantor EE. Diagnostic challenges in nephrotic syndrome presenting with venous thromboembolism. Cureus [Internet]. 2024 [cited 2025 Feb 14]; 16(10): e71173. Available from: https://pubmed.ncbi.nlm.nih.gov/39525223/
6. Na SP, Ning ML, Ma JF, Liang S, Wang YL, Sui MS, et al. Association of elevated circulating monocyte-platelet aggregates with hypercoagulability in patients with nephrotic syndrome. Thromb J [Internet]. 2024 [cited 2025 Feb 14];22(1):56. Available from: https://pubmed.ncbi.nlm.nih.gov/38943162/
7. El-Bardissy A, Elshafei MN, Abdelgawad H, Mekkawi R, Eltahir A, Mohammed A, et al. Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in nephrotic syndrome patients: a retrospective study. Thromb J [Internet]. 2025 [cited 2025 Jul 10];23(1):9. Available from: https://pubmed.ncbi.nlm.nih.gov/39885575/
8. Parker K, Choudhuri S, Lewis P, Thachil J, Mitra S. UK prescribing practice of anticoagulants in patients with chronic kidney disease: a nephrology and haematology-based survey. BMC Nephrol [Internet]. 2023 [cited 2025 Feb 14] ;24(1):9. Available from: https://pubmed.ncbi.nlm.nih.gov/36635661/
9. Liu YM, Gao S, Liu LJ. The risk of thromboembolic events in patients with nephrotic syndrome and relatively high albumin levels: a study over 10 years. BMC Nephrol [Internet]. 2024 [cited 2025 Feb 14];25(1):301. Available from: https://pubmed.ncbi.nlm.nih.gov/39261806/
10.Tarragón B, Han H, Navarro-Torres M, Canetta P, Wooden B, Derebail VK, et al. Prophylactic anticoagulation in patients with nephrotic syndrome in the Cure Glomerulonephropathy (CureGN) cohort. Clin Kidney J [Internet]. 2025 [cited 2025 Oct 3];18(5):sfaf104. Available from: https://pubmed.ncbi.nlm.nih.gov/40357500/
11.Ponticelli C, Moroni G. Correction: Nephrotic syndrome: pathophysiology and consequences. J Nephrol [Internet]. 2025 [cited 2025 Feb 14];38(7):2025. Available from: https://pubmed.ncbi.nlm.nih.gov/40782184/
12.Cooley I, Derebail VK, Gibson KL, Álvarez C, Poulton CJ, Blazek LN, et al. Association of lupus nephritis histopathologic classification with venous thromboembolism—modification by age at biopsy. Kidney Int Rep [Internet]. 2021 [cited 2025 Feb 14];6(6):1653–60. Available from: https://pubmed.ncbi.nlm.nih.gov/34169206/
13.Van Meerhaeghe T, Cez A, Dahan K, Esteve E, Elalamy I, Boffa JJ, Ponlot E. Apixaban prophylactic anticoagulation in patients with nephrotic syndrome. TH Open [Internet]. 2022 [cited 2025 Feb 14];6(4):e299–303. Available from: https://pubmed.ncbi.nlm.nih.gov/36299618/
14.Frățilă VG, Lupușoru G, Sorohan BM, Obrișcă B, Mocanu V, Lupușoru M, Ismail G. Nephrotic syndrome: From pathophysiology to novel therapeutic approaches. Biomedicines [Internet]. 2024 [cited 2025 Feb 14];12(3): 569. Available from: https://doi.org/10.3390/biomedicines12030569
15.Han X, Zhao P, Wang Z, Ji X, Zhao M. Acute lower extremity arterial thrombosis associated with nephrotic syndrome in adults: case series and literature review. BMC Nephrol [Internet]. 2023 [cited 2025 Feb 14];24(1):318. Available from: https://pubmed.ncbi.nlm.nih.gov/37884862/
16.Gounden V, Vashisht R, Jialal I. Hipoalbuminemia. [Updated August, 28 2023]. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. [cited 2025 Feb 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526080/
17.Parker K, Ragy O, Hamilton P, Thachil J, Kanigicherla D. Thromboembolism in nephrotic syndrome: controversies and uncertainties. Res Pract Thromb Haemost [Internet]. 2023 [cited 2025 Feb 14];7(6):102162. Available from: https://pubmed.ncbi.nlm.nih.gov/37680313/
18.Sirvent AE, Urzola-Rodríguez G, Lorenzo A, Callejas-Martínez R, Saiz A, Calle-García L, et al. Arterial thrombosis in a patient with nephrotic syndrome and antithrombin Cambrigde II. Nefrología (Engl Ed) [Internet]. 2022 [cited 2025 Feb 14];42(6):729–31. Available from: https://www.revistanefrologia.com/es-arterial-thrombosis-in-patient-with-articulo-S2013251423000330
19.Verma PR, Patil P. Nephrotic syndrome: A review. Cureus [Internet]. 2024 [cited 2025 Feb 14]; 16(2): e53923. Available from: https://pubmed.ncbi.nlm.nih.gov/38465146/
20.Kelddal S, Hvas AM, Grove EL, Birn H. Safety and effectiveness of direct oral anticoagulants in patients with nephrotic syndrome: a report of 21 cases. BMC Nephrol [Internet]. 2022 [cited 2025 Feb 14];23(1):305. Available from: https://pubmed.ncbi.nlm.nih.gov/36064370/
21.Li J, Wang X, Jiang S, Li W. Serum PLA2R antibody as a predictive biomarker for venous thromboembolism risk in primary membranous nephropathy. Med Clin (Barc) [Internet]. 2023 [cited 2025 Feb 14];161(10):417–21. Available from: https://pubmed.ncbi.nlm.nih.gov/37532619/ Subscription required
22.Allison SP, Lobo DN. The clinical significance of hypoalbuminaemia. Clin Nutr [Internet]. 2024 [cited 2025 Feb 14];43(4):909–14. Available from: https://pubmed.ncbi.nlm.nih.gov/38394971/
23.Azarniouch DM, Crona DJ, Karnabi P, Bose B, Nachman PH, Carrier M, et al. Anticoagulation for the prevention of thrombotic events in nephrotic syndrome. Kidney Int Rep [Internet]. 2024 [cited 2025 Feb 14];9(10):3053–6. Available from: https://pubmed.ncbi.nlm.nih.gov/39430178/
24.Welander F, Holmberg H, Dimény E, Jansson U, Själander A. Prophylactic anticoagulants to prevent venous thromboembolism in patients with nephrotic syndrome—A retrospective observational study. PLoS One [Internet]. 2021 [cited 2025 Feb 14];16(7):e0255009. Available from: https://pubmed.ncbi.nlm.nih.gov/34319998/
25.Waller AP, Troost JP, Parikh SV, Wolfgang KJ, Rovin BH, Nieman MT, et al. Nephrotic syndrome disease activity is proportional to its associated hypercoagulopathy. Thromb Res [Internet]. 2021 [cited 2025 Feb 14];201:50–9. Available from: https://pubmed.ncbi.nlm.nih.gov/33636573/
26.Gholizadeh Ghozloujeh Z, Glassock RJ, Al Jurdi A, Jhaveri KD, Heidari-Bateni G, Bajpai D, et al. Venous thromboembolism prevention in nephrotic syndrome: The role of aspirin, vitamin K antagonists, and direct oral anticoagulants. Kidney Int Rep [Internet]. 2025 [cited 2025 Oct 10] ;10(5):1335–45. Available from: https://pubmed.ncbi.nlm.nih.gov/40485694/
27.Chi G, Lee JJ, Memar Montazerin S, Marszalek J. Association of D-dimer with short-term risk of venous thromboembolism in acutely ill medical patients: A systematic review and meta-analysis. Vasc Med [Internet]. 2022 [cited 2025 Feb 14];27(5):478–86. Available from: https://doi.org/10.1177/1358863x221109855
28.Rovin BH, Adler SG, Barratt J, Bridoux F, Burdge KA, Chan TM, et al. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int [Internet]. 2021 [cited 2025 Feb 14];100(4 Suppl):S1–276. Available from: https://pubmed.ncbi.nlm.nih.gov/34556256/
29.Cubilier E, Chergui Y, Garrouste C, Ramos I, Philipponnet C, Atenza A, et al. Nephrotic syndrome thromboprophylaxis with direct oral anticoagulants or vitamin K antagonists. Kidney Int Rep [Internet]. 2025 [cited 2025 Oct 10];10(5):1468–75. Available from: https://pubmed.ncbi.nlm.nih.gov/40485718/
30.Tian Y, Sun B, Sun G. Research progress of nephrotic syndrome accompanied by thromboembolism. Int Urol Nephrol [Internet]. 2023 [cited 2025 Feb 14];55(7):1735–45. Available from: https://pubmed.ncbi.nlm.nih.gov/36757656/ Subscription required
31.Zhu H, Xu L, Liu X, Liu B, Zhai Ch, Wang R, Yang X. Anti-PLA2R antibody measured by ELISA predicts the risk of vein thrombosis in patients with primary membranous nephropathy. Ren Fail [Internet]. 2022 [cited 2025 Feb 14];44(1):594–600. Available from: https://pubmed.ncbi.nlm.nih.gov/35380081/
32.Jeyalan V, Stauss M, Liew Kang S, Ponnusamy A. A retrospective analysis of venous thromboembolism incidence amongst patients with membranous nephropathy: A single centre experience. Is anti-PLA2R an accessory or an accomplice?. [Poster-469]. Kidney Int Rep [Internet]. 2022 [cited 2025 Feb 14];7(Suppl 2):S209. Available from: https://www.kireports.org/article/S2468-0249(22)00499-5/fulltext
33.Vestergaard SV, Birn H, Darvalics B, Nitsch D, Sørensen HT, Christiansen ChF. Risk of arterial thromboembolism, venous thromboembolism, and bleeding in patients with nephrotic syndrome: A population-based cohort study. Am J Med [Internet]. 2022 [cited 2025 Feb 14];135(5):615–25.e9. Available from: https://pubmed.ncbi.nlm.nih.gov/34979093/ Subscription required
34.McDonnell T, Hartemink J, Ragy O, Parker K, Shukkur M, Thachil J, Kanigicherla D. Longitudinal analysis of prophylactic anticoagulation in primary nephrotic syndrome: Low incidence of thromboembolic complications. Glomerular Dis [Internet]. 2023 [cited 2025 Feb 14];3(1):266–74. Available from: https://pubmed.ncbi.nlm.nih.gov/38054033/
35.Tijani A, Coons EM, Mizuki B, Dermady M, Stanilova K, Casey AL, et al. Direct oral anticoagulants versus warfarin for venous thromboembolism prophylaxis in patients with nephrotic syndrome: A retrospective cohort study. Ann Pharmacother [Internet]. 2023 [cited 2025 Feb 14];57(7):787–94. Available from: https://pubmed.ncbi.nlm.nih.gov/36214262/ Subscription required
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