A 40-year-old man with nephrotic syndrome (albumin 1.9 g/dL, proteinuria 8 g/day) presents with sudden-onset right flank pain and haematuria. He has right leg swelling. Doppler shows right renal vein thrombosis. Which underlying histology is MOST strongly associated with this complication?
- A Minimal change disease
- B Membranous nephropathy ✓
- C Focal segmental glomerulosclerosis
- D IgA nephropathy
Correct answer: B. Membranous nephropathy
Explanation
Membranous nephropathy has the strongest association with renal vein thrombosis among nephrotic syndromes due to urinary loss of antithrombin III, protein S, and protein C, combined with increased hepatic synthesis of procoagulant factors. Distractor A (minimal change) rarely causes RVT. Distractors C and D are less strongly associated than membranous. This is a well-established high-yield association.
Reference: Brenner and Rector's The Kidney, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.