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Risk of venous thrombosis in patients with chronic kidney disease: identification of high‐risk groups

Summary Background Although an association between venous thrombosis and chronic kidney disease has recently been established, it is unknown which patients with chronic kidney disease are most likely to benefit from thromboprophylaxis. Objective The aim of this study was to assess the association be...

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Published in:Journal of thrombosis and haemostasis 2013-04, Vol.11 (4), p.627-633
Main Authors: Ocak, G., Lijfering, W. M., Verduijn, M., Dekker, F. W., Rosendaal, F. R., Cannegieter, S. C., Vossen, C. Y.
Format: Article
Language:English
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Summary:Summary Background Although an association between venous thrombosis and chronic kidney disease has recently been established, it is unknown which patients with chronic kidney disease are most likely to benefit from thromboprophylaxis. Objective The aim of this study was to assess the association between venous thrombosis and chronic kidney disease in combination with arterial thrombosis, malignancy, surgery and thrombophilia to identify high‐risk groups as a basis for personalized prevention. Methods This study included 2473 consecutive patients with first venous thrombosis and 2936 controls from a case–control study (the MEGA study). Results Moderately decreased kidney function (eGFR 30–60 mL min−1) was associated with a 2.5‐fold (95% CI, 1.9–3.4) increased risk and severely decreased kidney function (eGFR  90 mL min−1). The risk of venous thrombosis was additionally increased for moderately and severely reduced kidney function in combination with arterial thrombosis (odds ratio, 4.9; 95% CI, 2.2–10.9), malignancy (5.8; 95% CI, 2.8–12.1), surgery (14.0; 95%, CI 5.0–39.4), immobilization (17.1; 95% CI, 6.8–43.0) or thrombophilia (odds ratios, 4.3–9.5), with particularly high risks when three or more risk factors were present (odds ratio, 56.3; 95% CI, 7.6–419.3). Conclusion Decreased kidney function is associated with an increased risk of venous thrombosis. The risk increased substantially in the presence of one or more other risk factors for thrombosis.
ISSN:1538-7933
1538-7836
1538-7836
DOI:10.1111/jth.12141