Abstract P192: Chronic Kidney Disease and the Risk of Venous Thromboembolism in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Background: Chronic kidney disease (CKD) is a recently identified risk factor for venous thromboembolism (VTE) in whites, but there is little data available in blacks and it is not known which measure of CKD is best able to predict VTE.
Hypothesis: CKD by 4 different measures will be independently associated with VTE.
Methods: REGARDS enrolled 30,239 black and white men and women age 45 and older between 2003-7. We validated 298 VTE events by medical record review over 3.5 years follow-up. Hazard ratios (HRs) of VTE were calculated for categories of the CKD-EPI creatinine (eGFRcr), cystatin C (eGFRcys) and combined creatinine-cystatin C (eGFRcr-cys) equations, and urinary albumin-creatinine ratio (ACR) <30, 30-<300 and ≥300mg/g. Models were adjusted for covariates shown in the table. We tested for interactions of each CKD measure with race, sex and age. We calculated the C-index for each CKD measure in predicting VTE.
Results: Unadjusted C-indices for eGFRcr, eGFRcys, eGFRcr-cys and ACR were 0.59, 0.63, 0.63 and 0.55, respectively. There was a graded increase in incidence rates and HRs of VTE by eGFR (see table), but no association between ACR and VTE (not shown). There was modest confounding by demographic factors but not by other risk factors. There were no interactions between any of the 4 CKD measures and age or race. A significant interaction for sex and eGFRcr and eGFRcys, with stronger associations in women than men, did not persist after adjustment for covariates.
Conclusions: In this biracial cohort, CKD was associated with increased risk of VTE across categories of worsening eGFR. Cystatin-based eGFR equations had better discrimination than the creatinine based equation.
Author Disclosures: K.L. Cheung: None. N.A. Zakai: None. P. Callas: None. A.R. Folsom: None. C.A. Peralta: B. Research Grant; Modest; Labcorp Inc.. S.E. Judd: None. M. Kurella Tamura: None. M. Cushman: None.
- © 2015 by American Heart Association, Inc.