Chinese Medical Sciences Journal ›› 2018, Vol. 33 ›› Issue (2): 91-99.doi: 10.24920/11809
• Original Article • Previous Articles Next Articles
Zou Peimei1, Li Hang1, Cai Jianfang1, Chen Zhenjie1, Li Chao1, Xu Ping2, Li Mingxi1, Chen Limeng1, Li Xuemei1(), Li Xuewang1, *
Received:
2017-10-20
Published:
2018-06-30
Online:
2018-05-07
Contact:
Li Xuewang
E-mail:xuewanglee@126.com
This large retrospective study investigated the incidence and risk factors for thromboembolic events in IMN patients. The authors found increased incidences for ATE and VTE, especially in 6 month after diagnosis of the disease. Severe proteinuria, hypoalbuminemia, and those risk factors for atherosclerosis were found to be associated with thromboembolic events. |
Zou Peimei, Li Hang, Cai Jianfang, Chen Zhenjie, Li Chao, Xu Ping, Li Mingxi, Chen Limeng, Li Xuemei, Li Xuewang. A Cohort Study of Incidences and Risk Factors for Thromboembolic Events in Patients with Idiopathic Membranous Nephropathy[J].Chinese Medical Sciences Journal, 2018, 33(2): 91-99.
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ATEs (n=71) | VTEs (n=53) | Pvalue | |
---|---|---|---|
Sex, n (%) | 0.84 | ||
Male | 44(62.0) | 34(64.2) | |
Female | 27(38.0) | 19(35.8) | |
Age, year | 57.0±11.9 | 49.6±14.8 | 0.003 |
History of | |||
Smoking, n(%) | 31 (43.7) | 15 (28.3) | 0.08 |
Hypertension, n (%) | 46 (64.8) | 26 (49.1) | 0.08 |
Diabetes, n(%) | 16 (22.5) | 14 (26.4) | 0.62 |
Prior ATE, n(%) | 4 (5.6) | 2 (3.8) | 0.63 |
Observation time, month | 43.2 (5.4, 145.1) | 43.6 (21.5, 62.0) | 0.41 |
Proteinuria, g/24 h | 6.38 (3.79, 10.16) | 7.30 (4.88, 10.54) | 0.15 |
Serum albumin, g/L | 26.7±6.3 | 25.8±6.6 | 0.45 |
eGFR, ml/min/1.73 m2 | 88.65±22.27 | 97.22±18.86 | 0.03 |
Total cholesterol, mmol/L | 7.98±2.42 | 8.87±2.84 | 0.11 |
Triglycerides, mmol/L | 2.43 (1.81, 3.60) | 3.32 (1.96, 4.71) | 0.10 |
LDL-C, mmol/L | 5.41±2.19 | 5.63±2.48 | 0.68 |
NS, n (%) | 49 (69.0) | 38 (71.7) | 0.75 |
"
Characteristics | ATEs (n=58) | VTEs (n=56) | P value? | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean/ Median | Early onset (n=27) | Delayed onset (n=31) | P value* | Mean/ Median | Early onset (n=48) | Delayed onset (n=8) | P value* | |||
Age, year | 59.0±11.4 | 59.4±11.8 | 58.7±11.2 | 0.81 | 50.0±15.4 | 49.0±16.0 | 56.4±9.5 | 0.21 | 0.001 | |
Proteinuria, g/24 h | 3.5(1.05, 7.12) | 4.5(2.0, 6.7) | 2.8(0.7, 7.8) | 0.33 | 6.2(4.5, 9.6) | 6.2(4.5, 9.8) | 6.7(4.4, 9.2) | 0.76 | 0.002 | |
Serum albumin, g/L | 29.8±8.0 | 26.8±7.6 | 32.4±7.5 | 0.01 | 25.1±7.7 | 25.1±8.1 | 25.1±5.8 | 1.00 | 0.002 | |
eGFR, ml/min/ 1.73m2 | 84.2±22.1 | 87.5±20.8 | 81.6±23.1 | 0.35 | 94.8±22.3 | 96.6±21.4 | 84.0±26.3 | 0.14 | 0.02 | |
Total cholesterol, mmol/L | 7.4(5.1, 8.9) | 7.8(6.5, 8.9) | 6.1(4.9, 9.3) | 0.11 | 8.0(6.3, 9.3) | 8.4±2.7 | 7.9±1.4 | 0.66 | 0.21 | |
Triglycerides, mmol/L | 2.1(1.7, 3.0) | 2.1(1.7, 4.3) | 2.6(1.1, 2.9) | 0.75 | 3.4(1.9, 4.4) | 3.4(2.0, 4.0) | 1.9(1.6, 4.8) | 0.63 | 0.04 | |
LDL-C, mmol/L | 4.3(2.7, 6.5) | 5.5(2.7, 6.7) | 3.8(2.6, 6.4) | 0.27 | 4.5(3.4, 7.0) | 4.5(3.3, 7.2) | 4.51(3.45, -) | 0.87 | 0.54 | |
NS, n (%) | < 0.001 | |||||||||
NS status | 24 (42.1) | 16 (59.3) | 8 (26.7) | 0.01 | 44 (81.5) | 38 (79.2) | 6 (75.0) | N/A | ||
Sub-NS | 22 (38.6) | 10 (37.0) | 12 (38.7) | 8 (14.8) | 8 (16.7) | 0 (0.0) | ||||
CR | 11 (19.3) | 1 (3.7) | 10 (35.5) | 2 (3.7) | 2 (4.2) | 0 (0.0) |
"
Variables | n | ATE | VTE | |||||
---|---|---|---|---|---|---|---|---|
HR | 95% CI | Pvalue | HR | 95% CI | P value | |||
Sex, male | 449 | 1.2 | 0.8-2.0 | 0.39 | 1.6 | 0.8-2.4 | 0.29 | |
Age, years | 766 | < 0.001 | 0.35 | |||||
<35 | 167 | 1.0 | reference | 1.0 | reference | |||
35-54 | 323 | 5.1 | 1.2-21.7 | 0.8 | 0.4-1.7 | |||
≥55 | 276 | 13.0 | 3.1-53.3 | 1.3 | 0.6-2.6 | |||
History of | 766 | |||||||
Smoking | 228 | 1.7 | 1.0-2.7 | 0.03 | 0.9 | 0.5-1.7 | 0.81 | |
Hypertension | 360 | 1.8 | 1.1-3.0 | 0.02 | 0.9 | 0.5-1.6 | 0.77 | |
Diabetes | 90 | 1.5 | 0.8-2.8 | 0.24 | 1.3 | 0.6-2.9 | 0.44 | |
ATE | 35 | 2.4 | 1.1-5.2 | 0.03 | 0.8 | 0.2-3.4 | 0.79 | |
Proteinuria, g/24 h | 712 | 0.04 | 0.03 | |||||
<3.5 | 191 | 1.0 | reference | 1.0 | reference | |||
3.5-8.0 | 313 | 1.3 | 0.7-2.7 | 3.6 | 1.3-10.5 | |||
>8.0 | 208 | 2.2 | 1.1-4.4 | 4.3 | 1.5-12.8 | |||
Serum albumin, g/L | 710 | 0.64 | 0.01 | |||||
<20 | 73 | 1.6 | 0.6-4.4 | 5.5 | 1.5-19.9 | |||
20-35 | 198 | 1.4 | 0.6-3.0 | 2.3 | 0.7-7.6 | |||
≥35 | 246 | 1.0 | reference | 1.0 | reference | |||
eGFR, ml/min/1.73 m2 | 760 | 0.10 | 0.27 | |||||
≥90 | 517 | 1.0 | reference | 1.0 | reference | |||
60-89 | 195 | 1.4 | 0.8-2.4 | 1.4 | 0.8-2.5 | |||
<60 | 48 | 2.2 | 1.0-4.8 | 0.3 | 0.1-2.4 | |||
Total cholesterol, mmol/L | 543 | 0.97 | 0.14 | |||||
<5.18 | 43 | 1.0 | reference | 1.0 | reference | |||
5.18-7.76 | 240 | 0.9 | 0.3-2.4 | 2.4 | 0.3-18.3 | |||
>7.76 | 260 | 0.9 | 0.3-2.3 | 4.1 | 0.6-30.5 |
"
ATE | VTE | |||||||
---|---|---|---|---|---|---|---|---|
Variables | HR | 95% CI | Pvalue | Variables | HR | 95% CI | Pvalue | |
History of | Serum albumin, g/L | 0.03 | ||||||
Smoker | 1.4 | 0.8-2.4 | 0.19 | <20 | 3.2 | 0.8-12.5 | ||
ATE | 1.6 | 0.7-3.5 | 0.28 | 20-35 | 1.3 | 0.4-4.5 | ||
Hypertension | 1.1 | 0.6-1.8 | 0.84 | ≥35 | 1.0 | reference | ||
Age, years | 0.001 | |||||||
<35 | 1.0 | reference | ||||||
35-54 | 4.4 | 1.0-19.1 | ||||||
≥55 | 9.2 | 2.2-39.5 | ||||||
Proteinuria, g/24 h | 0.11 | Proteinuria, g/24 h | 0.13 | |||||
<3.5 | 1.0 | reference | <3.5 | 1.0 | reference | |||
3.5-8.0 | 1.1 | 0.6-2.3 | 3.5-8.0 | 3.0 | 1.0-8.9 | |||
>8.0 | 1.9 | 0.9-3.8 | >8.0 | 3.2 | 1.0-10.1 |
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