Chronic kidney disease stages 1–3 increase the risk of venous thrombosis

Ocak, Gürbey; Verduijn, Marion; Vossen, C. Y.; Lijfering, Willem M.; Dekker, Friedo W.; Rosendaal, Frits R.; Gansevoort, Ronald; Mahmoodi, Bakhtawar K.

doi:10.1111/j.1538-7836.2010.04048.x

Cited by 45 publications

(47 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study reported that individuals with an estimated glomerular filtration rate between 15 and 60 mL min À1 had a 2.1-fold increased risk of venous thrombosis as compared with those with a normal kidney function. Recently, we confirmed these results in the Prevention of Renal and Vascular Disease (PREVEND) cohort study [5]. The moderately increased risk found in the above studies for chronic kidney disease probably does not justify the use of thromboprophylaxis when weighed against the thromboprophylaxis-related risk of major bleeding episodes [6].…”

Section: Introductionsupporting

confidence: 57%

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

Ocak

Lijfering

Verduijn

et al. 2013

Journal of Thrombosis and Haemostasis

Self Cite

View full text Add to dashboard Cite

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 < 30 mL min−1) was associated with a 5.5‐fold (95% CI 1.8–16.7) increased risk of venous thrombosis, compared with those with normal 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.

show abstract

Section: Introductionsupporting

confidence: 57%

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

Ocak

Lijfering

Verduijn

et al. 2013

Journal of Thrombosis and Haemostasis

Self Cite

View full text Add to dashboard Cite

show abstract

“…In both the Longitudinal Investigation of Thromboembolism Etiology (LITE) 4 and Prevention of Renal and Vascular End-Stage Disease (PREVEND) 5 study, chronic kidney disease was associated with an increased risk of venous thrombosis. However, in neither study were factors that might explain the association between chronic kidney disease and venous thrombosis identified.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with subjects with an eGFR >50th percentile, the adjusted mean factor levels were significantly different from subjects with an eGFR <1st percentile for fibrinogen (adjusted mean difference, 0.7 g/L; 95% CI, 0.5-0.9), factor VII (31 IU/ dL; 95% CI, 22-40), factor IX (12 IU/dL; 95% CI, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], and factor XI (10 IU/dL; 95% CI, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17], with a most pronounced increase in factor VIII (60 IU/dL; 95% CI, 44-76) and von Willebrand factor (60 IU/dL; 95% CI, 43-77). A 10-mL/min decrease in eGFR was associated with an increase of 3 IU/dL (95% CI, 2-4) in factor VIII levels and an increase of 2 IU/ dL (95% CI, 1-3) in von Willebrand factor levels.…”

Section: Hemostatic Factor Levels In Controls In Relation To Kidney Fmentioning

confidence: 99%

See 1 more Smart Citation

Role of Hemostatic Factors on the Risk of Venous Thrombosis in People With Impaired Kidney Function

et al. 2014

View full text Add to dashboard Cite

Background— Factors explaining the association between impaired kidney function and venous thrombosis have not been identified so far. The aim of our study was to determine whether the association between impaired kidney function and venous thrombosis can be explained by the concurrent presence of genetic or acquired venous thrombosis risk factors. Methods and Results— The glomerular filtration rate was estimated (eGFR) in 2473 venous thrombosis patients and 2936 controls from a population-based case–control study. Kidney function was grouped into 6 categories based on percentiles of the eGFR in the controls (>50th [reference], 10th–50th, 5th–10th, 2.5th–5th, 1st–2.5th, and <1st percentile). Several hemostatic factors showed a procoagulant shift with decreasing kidney function in controls, most notably factor VIII and von Willebrand factor. Compared with eGFR >50th percentile, factor VIII levels (adjusted mean difference, 60 IU/dL for the <1st eGFR percentile category) and von Willebrand factor levels (adjusted mean difference, 60 IU/dL for the <1st eGFR percentile category) increased with each percentile category. The odds ratios for venous thrombosis similarly increased across the categories from 1.1 (95% confidence interval, 0.9–1.3) for the 10th to 50th percentile to 3.7 (95% confidence interval, 2.4–5.7) for the <1st percentile category. Adjustment for factor VIII or von Willebrand factor attenuated these odds ratios, indicating an effect of eGFR on thrombosis through these factors. Adjustments for other risk factors for venous thrombosis did not affect the odds ratios. Conclusion— Impaired kidney function affects venous thrombosis risk via concurrently raised factor VIII and von Willebrand factor levels.

show abstract

“…Patients with chronic kidney disease (CKD) have increased risks of endothelial dysfunction and thrombosis (1,2). Systemic inflammation may contribute to endothelial dysfunction and accelerated thrombus formation in CKD (3).…”

Section: Introductionmentioning

confidence: 99%

Von Willebrand factor, ADAMTS13 activity, TNF-α and their relationships in patients with chronic kidney disease

Shen¹,

Lu²,

Dong³

et al. 2011

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Patients with chronic kidney disease (CKD) often exhibit associated endothelial dysfunction and inflammation. Systemic inflammation may contribute to the endothelial dysfunction and accelerated thrombosis observed in CKD patients. In this study, we assessed the relationships among endothelial dysfunction, a disintegrin-like and metalloprotease with thrombospondin type 1 repeats 13 (ADAMTS13) activity and levels of inflammatory cytokines in CKD patients. CKD patients were classified into three groups: The chronic glomerulonephritis group (CGN; n=31), the idiopathic nephritic syndrome group (NS; n=32) and the lupus nephritis group (LN; n=41). We measured the plasma levels of tumor necrosis factor-α (TNF-α), von Willebrand factor (VWF) antigen (VWF:Ag) and ADAMTS13 activity using an ELISA-based method in CKD patients (n=104) and normal controls (n=32). The ratio of the VWF:Ag levels to ADAMTS13 activity was calculated. The VWF:Ag levels were significantly higher and the ADAMTS13 activities were significantly lower in the disease groups compared to the controls (P<0.01). ADAMTS13 activity was lower in the NS group compared to the CGN and LN groups (P<0.05). The TNF-α levels were higher in the CKD group compared to the control group (P<0.01). TNF-α was positively correlated with the VWF:Ag levels (r= 0.242, P= 0.013) and negatively correlated with the glomerular filtration rate (GFR) (r=-0.193, P=0.049). ADAMTS13 activity was negatively correlated with the cholesterol levels in CKD patients (r=-0.2, P= 0.042). TNF-α levels in CKD were positively correlated with the VWF:Ag levels and negatively correlated with GFR, which indicates that inflammation may be a major cause of endothelial dysfunction and an index of renal function. The VWF:Ag levels increased and ADAMTS13 activity decreased in CKD patients, which indicates that CKD leads to a prothrombotic state.

show abstract

Chronic kidney disease stages 1–3 increase the risk of venous thrombosis

Cited by 45 publications

References 35 publications

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

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

Role of Hemostatic Factors on the Risk of Venous Thrombosis in People With Impaired Kidney Function

Von Willebrand factor, ADAMTS13 activity, TNF-α and their relationships in patients with chronic kidney disease

Contact Info

Product

Resources

About