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Nephrotic Syndrome DVT Anticoagulation — ESENeph MCQ

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HardGlomerulonephritisNephrotic Syndrome DVT AnticoagulationESENeph

A patient with membranous-nephropathy nephrosis develops a proximal DVT. After initial therapeutic anticoagulation, albumin remains 18 g/L and proteinuria 9 g/day at six months. How should duration be approached?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Continue therapeutic anticoagulation while the nephrotic risk factor remains active

Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as E

B is correct. KDIGO states that thromboembolism occurring in nephrotic syndrome requires full anticoagulation, commonly for 6–12 months and/or for the duration of nephrosis. At six months this patient retains the provoking risk—marked hypoalbuminaemia and heavy proteinuria—so automatic cessation is inappropriate. The endpoint is not necessarily lifelong: remission can materially reduce risk and permits reassessment. Bleeding risk, kidney function, drug protein binding, interactions and the chosen anticoagulant are reviewed throughout. Symptom resolution does not demonstrate thrombus resolution or loss of the prothrombotic state.

Reference: KDIGO 2021 glomerular-disease guideline: https://kdigo.org/wp-content/uploads/2021/10/KDIGO-2021-Guideline-for-the-Management-of-Glomerular-Diseases.pdf