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Longitudinal clinical and laboratory parameters considered included serum creatinine, albumin, cholesterol and triglycerides, and 24-hour urine protein excretion and estimated GFR (e GFR) using the four-variable Modification of Diet in renal Disease equation (12).

Medications considered included immunosuppressants, anticoagulants, and antiplatelet (aspirin, clopidogrel, dipyridamole) agents.

Most venous thromboembolic events occurred within 2 years of first clinical assessment (median time to VTE = 3.8 months).

After adjusting for age, sex, proteinuria, and immunosuppressive therapy, hypoalbuminemia at diagnosis was the only independent predictor of a venous thromboembolic event.

Each 1.0 g/dl reduction in serum albumin was associated with a 2.13-fold increased risk of VTE.

An albumin level We studied a large pooled inception cohort of patients identified at the time of biopsy diagnosis of GN and followed by prospective accrual of data from each clinic visit (10,11).

Thrombi diagnosed simultaneously at different sites were considered as a single event.

PE was confirmed by ventilation-perfusion scanning, spiral computed tomography, or angiography; DVT by compression ultrasound or venography; and RVT by renal venogram, Doppler ultrasound, or magnetic resonance angiography. Data extracted from medical records included demographics, clinical variables, medication exposures, and information regarding malignancy, smoking, previous VTE, immobilization within 6 weeks or pregnancy within 3 months of VTE, or use of hormone therapy at the time of VTE.

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The difference in the frequency of VTE between patients who did and did not have a cancer was not significant (9.4% versus 7.2%, =0.46).For both registries, medical records were collected from the initial biopsy diagnosis or earliest available clinical presentation.All patients over age 16 with MN diagnosed and followed between 19 in the GDCN and between 19 in the TGNR were included.All use of warfarin was reviewed, and no patient received prophylactic anticoagulation because of the nephrotic syndrome.We reviewed hepatic hydroxymethyl glutaryl-Co A (HMG-Co A) reductase inhibitor exposure, as these agents have been associated with a reduced risk of VTE in the general population (13–15).

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