FP132
THROMBOEMBOLIC EVENTS IN CHINESE PATIENTS WITH PRIMARY MEMBRANOUS NEPHROPATHY

INTRODUCTION AND AIMS: The aims of this study were to access risks and characteristics of arterial thromboembolic events (ATEs) and venous thromboembolic events (VTEs) in a large cohort of Chinese patients with primary membranous nephropathy (PMN), and to identify predisposing risk factors. Besides, we tried to investigate the protective effects of aspirin and statin in thromboembolic events of PMN.

METHODS: A total of 766 consecutive Chinese patients with PMN were enrolled in this retrospective cohort study. We calculated the cumulative incidence rates of newly diagnosed symptomatic ATEs and VTEs. Univariable risk prediction models and multivariable survival analysis model were used to evaluate the potential risk factors. Propensity score matching analysis was used to access the protective effects of aspirin and statin.

RESULTS: At 0.5, 1, 2, 3, and 5 years after biopsy diagnosis of PMN, cumulative incidence rates of newly diagnosed ATEs were 4.31%, 5.69%, 6.25%, 7.10%, and 7.95%, while VTEs were 5.87%, 6.75%, 6.91%, 6.96%, and 7.15%, respectively. ATEs were mainly cardiovascular diseases (50%) and thrombotic ischemic stroke (45%), and VTEs were mostly deep venous thrombosis. ATEs were associated with higher proteinuria and classic risk factors for atherosclerosis, including age, smoking history, hypertension and prior ATE. Hypoalbuminemia was the dominant independent risk factor for VTE. Besides, VTEs tend to occur more frequently than ATEs when patients at nephrotic syndrome status. The usage of statins obviously decreased incidences of both ATEs and VTEs. Midium and high potency-dose statins were more efficiently protective than low potency-dose statins in ATEs, while in VTEs, the protective effects had no differences in these there groups of statins. In patients with not too low serum albumin level, aspirin can reduce VTEs, but had no effect in ATEs.

CONCLUSIONS: Patients with PMN were at high risks of ATEs and VTEs, especially within the first 6 months of the disease. In our cohort, ATEs were mainly cardiovascular diseases and thrombotic ischemic stroke, and VTEs were mostly deep venous thrombosis. Higher proteinuria and classic risk factors for atherosclerosis were associated with ATEs. Hypoalbuminemia independently predicted VTEs. Risks of both ATEs and VTEs were particularly high in the period of nephrotic syndrome. The usage of statins obviously decreased incidences of both ATEs and VTEs. In patients with not too low serum albumin level, aspirin can reduce VTEs, but had no effect in ATEs.