American Journal of Kidney Diseases
American Journal of Kidney Diseases
5 years ago

Risk of Venous Thromboembolism in Patients by Albuminuria and Estimated GFR

The risk for venous thromboembolism (VTE) is elevated with albuminuria or a low estimated glomerular filtration rate (eGFR). However, the VTE risk due to the combined effects of eGFR and albuminuria are unknown. Study Design Population-based cohort study. Settings & Participants 694,956 adults in Ontario, Canada, from 2002 to 2012. Factors eGFR and albumin-creatinine ratio (ACR). Outcome VTE. Results 15,180 (2.2%) VTE events occurred during the study period. Both albuminuria and eGFR were independently associated with VTE. The association of albuminuria and VTE differed by level of eGFR (P for ACR × eGFR interaction < 0.001). After considering the competing risk for death, there was a 61% higher rate of VTE in patients with normal eGFRs (eGFRs>90mL/min/1.73m2) and heavy albuminuria (ACR>300mg/g) compared with those with normal eGFRs and no albuminuria (subdistribution HR, 1.61; 95% CI, 1.38-1.89). Among those with reduced kidney function (eGFR, 15-29mL/min/1.73m2), the risk for VTE was only minimally increased, irrespective of albuminuria (subdistribution HRs of 1.23 [95% CI, 1-1.5] and 1.09 [95% CI, 0.82-1.45] for ACR<30 and >300mg/g, respectively). Limitations Only single determinations of ACR and eGFR were used. Diagnostic/International Classification of Diseases codes were used to define VTE. Conclusions Albuminuria increases the risk for VTE markedly in patients with normal eGFRs compared with those with lower eGFRs.

Publisher URL: www.sciencedirect.com/science

DOI: S0272638617308430

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