Gholizadeh Ghozloujeh Zohreh, Glassock Richard J, Al Jurdi Ayman, Jhaveri Kenar D, Heidari-Bateni Giv, Bajpai Divya, Lerma Edgar, Wu Junnan, Abdipour Amir, Norouzi Sayna
Division of Nephrology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA.
Geffen School of Medicine, University of California at Los Angeles, Laguna Niguel, California, USA.
Kidney Int Rep. 2025 Feb 21;10(5):1335-1345. doi: 10.1016/j.ekir.2025.02.010. eCollection 2025 May.
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.
肾病综合征（NS）与静脉血栓栓塞事件（VTEs）风险显著升高相关，而VTEs会导致发病和死亡。目前NS患者VTE预防指南基于有限的证据，主要来自观察性研究。本综述描述了NS高凝状态的复杂性，重点关注阿司匹林作为一种潜在预防药物的情况。我们概述了NS中VTE的病理生理学，强调了诸如低白蛋白血症、抗凝剂丢失和血小板反应性增强等因素。本综述还总结了关于阿司匹林在降低血栓栓塞风险方面作用的现有数据。虽然阿司匹林可能使特定患者群体受益，但其疗效仍不确定，一些研究表明阿司匹林与抗凝剂联合使用可更有效地降低风险。未来的研究，特别是大规模随机对照试验（RCTs），对于阐明阿司匹林在预防该人群VTE中的作用是必要的。我们的综述强调了需要制定个体化预防策略，以平衡NS患者的血栓形成和出血风险。
