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Nephrotic Syndrome Thrombosis — ESENeph MCQ

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ModerateGlomerulonephritisNephrotic Syndrome ThrombosisESENeph

A 34-year-old man with recently diagnosed minimal change disease and nephrotic syndrome (albumin 15 g/L) develops sudden-onset pleuritic chest pain and breathlessness. CT pulmonary angiogram confirms bilateral pulmonary emboli. What is the recommended approach to thromboprophylaxis in nephrotic syndrome with severe hypoalbuminaemia?

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Correct answer: C — Prophylactic anticoagulation should be considered when albumin is <20-25 g/L in high-risk nephrotic conditions

KDIGO 2021 GN guideline recommends considering prophylactic anticoagulation in nephrotic syndrome when serum albumin is <20-25 g/L, particularly in membranous nephropathy (highest thrombotic risk) and other high-risk scenarios. MCD with severe hypoalbuminaemia also carries thrombotic risk. This patient has had a proven PE and requires therapeutic anticoagulation. The question tests knowledge of when prophylaxis should have been started.

Reference: KDIGO 2021 – Glomerular Disease Guideline