Abstract 3475: Chronic Kidney Disease and Risk of Venous Thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE) Study
Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease (CVD) morbidity and mortality, but its association with incident venous thromboembolism (VTE) in nondialysis-dependent patients has not been evaluated in a community-based population. Using data from the Longitudinal Investigation of Thromboembolism Etiology, we categorized 19,073 middle-aged and elderly adults based on estimated glomerular filtration rate (eGFR) > 90, 60 – 89, and 15–59 ml/min/1.73 m2 representing normal kidney function, mildly decreased kidney function, and combined stage 3/4 CKD, respectively, and divided cystatin C (available in only 4734 participants) into quintiles. Venous thrombosis was identified from hospital records and was defined based on duplex ultrasound or venogram, and pulmonary embolism based on ventilation/perfusion scanning or computed tomography. Over a mean follow-up time of 11.8 years (224,275 person-years), 413 participants developed VTE. The incidence rates per 1000 person-years were 1.5, 1.9, and 4.5 for the normal kidney function, mildly decreased kidney function, and stage 3/4 CKD groups, respectively. Compared with participants with normal kidney function, the age, sex, race, and center adjusted relative risk of VTE was 1.28 (95% CI: 1.02–1.59) for those with mildly decreased kidney function and 2.09 (95% CI: 1.47–2.96) for those with stage 3/4 CKD. After additional adjustment for CVD risk factors, an increased risk of incident VTE was still observed in stage 3/4 CKD participants, with a multivariable adjusted relative risk of 1.71 (95% CI: 1.18 –2.49). There was no significant association between cystatin C and VTE. Middle-aged and elderly CKD patients who do not require dialysis or renal transplant are at increased risk for incident VTE. Attention to VTE prophylaxis seems particularly important in CKD.