Mednet Logo
CommunityNephrology

What is your approach to systemic anticoagulation for patients with hypoalbuminemia and nephrotic syndrome secondary to a non-membranous nephropathy condition?

Community PollStarted

At what serum albumin level do you initiate prophylactic anticoagulation in a patient with low bleeding risk and nephrotic syndrome secondary to a non-membranous nephropathy condition?

55 physicians have voted

Join Mednetto vote and see how they answered.

4 Answers
Mednet Member
Mednet MemberInvited Expert
Nephrology · Loyola University Health System
Answered on

Patients with nephrotic syndrome (NS) and hypoalbuminemia have a several-fold higher risk of venous thromboembolism (VTE) than the general population and also a somewhat higher risk of arterial thromboembolism (ATE), such as MI and stroke. This risk seems to be higher in membranous nephropathy (MN) ...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Nephrology · NewYork-Presbyterian / Columbia University Irving Medical Center
Answered on

All nephrotic proteinuria is associated with increased risk of thrombosis, but membranous nephropathy in particular has the highest associated risk (see Barbour et al., PMID 21918501). In adults with non-membranous nephrotic syndrome, I reserve anticoagulation for patients with a history of venous t...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Nephrology · Johns Hopkins University
Answered on

Generally, I prefer AC for patients with serially declining albumin (usually <2.5 g/dL) and proteinuria >10 g/g, as well as other risk factors for thrombosis (NYHA 3/4, immobilization, factor 5 Leiden, AF, history of VTE, etc.). The question is how quickly I can get the patient in remission, and how...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Nephrology · Johns Hopkins University
Answered on

Generally I prefer AC for patients with serially dropping albumin (usually below 2.5 g/dl) and proteinuria>10 g/g and other reasons fo

Join for free or sign in to see the full answer