Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants
Nephrotic syndrome (NS) is associated with a significantly elevated risk of venous thromboembolic events (VTEs), which contribute to morbidity and mortality. Current guidelines for VTE prophylaxis in patients with NS are based on limited evidence, primarily from observational studies. This review de...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-05-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024925000993 |
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| author | Zohreh Gholizadeh Ghozloujeh Richard J. Glassock Ayman Al Jurdi Kenar D. Jhaveri Giv Heidari-Bateni Divya Bajpai Edgar Lerma Junnan Wu Amir Abdipour Sayna Norouzi |
| author_facet | Zohreh Gholizadeh Ghozloujeh Richard J. Glassock Ayman Al Jurdi Kenar D. Jhaveri Giv Heidari-Bateni Divya Bajpai Edgar Lerma Junnan Wu Amir Abdipour Sayna Norouzi |
| author_sort | Zohreh Gholizadeh Ghozloujeh |
| collection | DOAJ |
| description | Nephrotic syndrome (NS) is associated with a significantly elevated risk of venous thromboembolic events (VTEs), which contribute to morbidity and mortality. Current guidelines for VTE prophylaxis in patients with NS are based on limited evidence, primarily from observational studies. This review describes the complexities of hypercoagulability in NS, with a focus on aspirin as a potential prophylactic agent. We outline the pathophysiology underlying VTE in NS, highlighting factors such as hypoalbuminemia, anticoagulant loss, and heightened platelet reactivity. This review also summarizes the available data on the role of aspirin in reducing thromboembolic risk. Although aspirin may benefit select patient groups, its efficacy remains inconclusive, with some studies suggesting a combination of aspirin and anticoagulants for more effective risk reduction. Future studies, particularly large-scale randomized controlled trials (RCTs), are necessary to clarify the role of aspirin in preventing VTEs in this population. Our review underscores the need for individualized prophylactic strategies that balance thrombotic and bleeding risks in patients with NS. |
| format | Article |
| id | doaj-art-d3761911275e4b2fa04b26b8af9a1783 |
| institution | OA Journals |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-d3761911275e4b2fa04b26b8af9a17832025-08-20T02:33:35ZengElsevierKidney International Reports2468-02492025-05-011051335134510.1016/j.ekir.2025.02.010Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral AnticoagulantsZohreh Gholizadeh Ghozloujeh0Richard J. Glassock1Ayman Al Jurdi2Kenar D. Jhaveri3Giv Heidari-Bateni4Divya Bajpai5Edgar Lerma6Junnan Wu7Amir Abdipour8Sayna Norouzi9Division of Nephrology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USAGeffen School of Medicine, University of California at Los Angeles, Laguna Niguel, California, USADivision of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Division of Kidney Diseases and Hypertension, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, New York, USADivision of Cardiology, Arrowhead Regional Medical Center, California University of Science and Medicine, Colton, California, USADivision of Nephrology, Seth GS Medical College and KEM Hospital, Mumbai, IndiaDepartment of Medicine, Section of Nephrology, Advocate Christ Medical Center, University of Illinois at Chicago, Oak Lawn, Illinois, USADepartment of Nephrology, Zhejiang University Medical College Affiliated Sir Run Run Shaw Hospital, Hangzhou, Zhejiang Province, ChinaDivision of Nephrology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USADivision of Nephrology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA; Correspondence: Sayna Norouzi, Department of Medicine, Division of Nephrology, Loma Linda University Medical Center, 11370 Anderson St, Loma Linda, California, USA.Nephrotic syndrome (NS) is associated with a significantly elevated risk of venous thromboembolic events (VTEs), which contribute to morbidity and mortality. Current guidelines for VTE prophylaxis in patients with NS are based on limited evidence, primarily from observational studies. This review describes the complexities of hypercoagulability in NS, with a focus on aspirin as a potential prophylactic agent. We outline the pathophysiology underlying VTE in NS, highlighting factors such as hypoalbuminemia, anticoagulant loss, and heightened platelet reactivity. This review also summarizes the available data on the role of aspirin in reducing thromboembolic risk. Although aspirin may benefit select patient groups, its efficacy remains inconclusive, with some studies suggesting a combination of aspirin and anticoagulants for more effective risk reduction. Future studies, particularly large-scale randomized controlled trials (RCTs), are necessary to clarify the role of aspirin in preventing VTEs in this population. Our review underscores the need for individualized prophylactic strategies that balance thrombotic and bleeding risks in patients with NS.http://www.sciencedirect.com/science/article/pii/S2468024925000993anticoagulationaspirinhypercoagulabilitynephrotic syndromevenous thromboembolic events |
| spellingShingle | Zohreh Gholizadeh Ghozloujeh Richard J. Glassock Ayman Al Jurdi Kenar D. Jhaveri Giv Heidari-Bateni Divya Bajpai Edgar Lerma Junnan Wu Amir Abdipour Sayna Norouzi Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants Kidney International Reports anticoagulation aspirin hypercoagulability nephrotic syndrome venous thromboembolic events |
| title | Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants |
| title_full | Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants |
| title_fullStr | Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants |
| title_full_unstemmed | Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants |
| title_short | Venous Thromboembolism Prevention in Nephrotic Syndrome: The Role of Aspirin, Vitamin K Antagonists, and Direct Oral Anticoagulants |
| title_sort | venous thromboembolism prevention in nephrotic syndrome the role of aspirin vitamin k antagonists and direct oral anticoagulants |
| topic | anticoagulation aspirin hypercoagulability nephrotic syndrome venous thromboembolic events |
| url | http://www.sciencedirect.com/science/article/pii/S2468024925000993 |
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