American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of glomerulopathy is often associated with renal vein thrombosis?

1. Minimal change disease

2. Membranous glomerulopathy

3. Focal segmental glomerulosclerosis

4. Diabetic nephropathy

The correct answer is: Membranous glomerulopathy

Membranous glomerulopathy is significantly associated with renal vein thrombosis due to its pathophysiological characteristics. This condition is characterized by the formation of immune complex-mediated subepithelial deposits in the glomerular membrane, leading to thickening of the membrane. The thickened glomerular membrane can contribute to nephron dysfunction and proteinuria, which in turn may alter the balance of fluid and form a hypercoagulable state. Patients with substantial proteinuria are at risk for thrombotic events, including renal vein thrombosis. The loss of antithrombotic factors trailing protein loss, coupled with the potential for increased clotting factors, enhances the likelihood of thrombus formation. Minimal change disease, focal segmental glomerulosclerosis, and diabetic nephropathy are less commonly associated with renal vein thrombosis. While these conditions can also lead to nephrotic syndrome, their pathophysiology does not typically result in the same severe alterations in the hemostatic balance seen in membranous glomerulopathy, making the association of renal vein thrombosis more prevalent in the latter.