[BP.12.08] CHRONIC KIDNEY DISEASE IS ASSOCIATED WITH INCREASED RISK OF VENOUS THROMBOEMBOLISM RECURRENCE. (September 2017)

• Record Type: Journal Article
• Authors: Rattazzi, M.; Villalta, S.; Sponchiado, A.; Galliazzo, S.; De Lucchi, L.; Faggin, E.; Pagliara, V.; Zilli, C.; Callegari, E.; Caberlotto, L.; Puato, M.; Pauletto, P.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000524039.56251.0c
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Chronic kidney disease (CKD) has been associated with increased risk of venous thromboembolism (VTE), but it is unclear whether the decline in renal function can also influence the risk of VTE recurrence. Design and method: We enrolled 396 patients who had a previous diagnosed episode of VTE. In this population we identified a group of 68 (17.7%) individuals, which also experienced at least one episode of VTE recurrence. Data collected from each patient were: age, sex, height, weight, BMI, blood pressure levels, history of atherosclerotic cerebro-cardiovascular events, known diabetes, and ongoing medications. Creatinine blood levels were measured in each patient at the enrollment and used to estimate GFR by using the 2009 CKD-EPI creatinine equation. The same cohort of patients was then followed for an average time of 44.3 ± 17.5 months (range 1–65 months) and reliable follow-up clinical data were obtained in 367 patients. During this time period 32 subjects (8.7%) had symptomatic recurrence of VTE. Results: Subjects with history of VTE recurrence were prevalently male with higher blood pressure levels and lower estimated glomerular filtration rate (GFR) as compared to patients without recurrent VTE. At baseline, the prevalence of CKD (GFR < 60 ml/min/1.73 m 2 ) was significantly higher in patients with history of VTE recurrence (22.1% vs 6.4%), with an adjusted odds ratio for recurrence of 4.45 (95% CI 2.05–10.06, p < 0.001). The longitudinal study confirmed baseline data as we found a significant 3.75 hazard ratio for VTE recurrence among patients with CKD (95% CI 1.57–8.94) as compared to subjects with normal renal function. A sizeable increase in the risk of recurrent VTE was also observed in patients with mild-to-moderate decline in renal function. In fact, the adjusted hazard ratio for recurrence was 3.72 (95% CI 1.26–10.97, p = 0.017) for patients in CKD stage 2 compared to patients with GFR > 90 ml/min/1.73 m 2 . Conclusions: Our study demonstrated that the presence of CKD is associated with a significant increase in the risk of recurrent VTE.