Venous Thromboembolism Risk After Hospitalization Tied to eGFR, Albuminuria – Renal and Urology News

Chronic kidney disease (CKD) parameters, including lower estimated glomerular filtration rate (eGFR) and albuminuria, are independently associated with venous thromboembolism (VTE) risk after hospitalization, a new study finds.

Aditya Surapaneni, PhD, of New York University (NYU) Grossman School of Medicine in New York, New York, and colleagues conducted a retrospective study including 23,899 and 11,552 adults hospitalized within Geisinger Health System and NYU Langone Health, respectively. In the Geisinger cohort, the VTE rate after hospital discharge ranged from 10.7 to 13.6 to 27.7 events per 1000 person-years in adults with CKD stage G1A1, G2A2, and G4-5A3, respectively, the investigators reported in the Clinical Journal of the American Society of Nephrology. Similarly, in the NYU cohort, the VTE rate after hospital discharge ranged from 11.7 to 15.7 to 27.1 events per 1000 person-years in adults with CKD stage G1A1, G2A2, and G4-5A3, respectively. The corresponding eGFR (in mL/min/1.73m²) and UACR (in mg/g) categories were eGFR more than 90 with UACR less than 30; eGFR less than 60 and UACR 30-300; and eGFR less than 30 and UACR more than 300, respectively.

The models were adjusted for other traditional VTE risk factors such as older age, obesity, smoking, cancer, fracture, coronary heart disease, diabetes, hypertension, heart failure, longer hospitalization, and use of anticoagulants and antiplatelets.

In pooled analyses, VTE risk after discharge significantly increased 6% for every 10 mL/min/m² decline in eGFR below a threshold of 60, the investigators reported. VTE risk also significantly increased 5% for every doubling of UACR.

Loss of anticoagulant proteins during albuminuria may contribute to VTE, according to the investigators. Gut-derived uremic toxins might increase platelet activation and promote thrombosis in patients with declining eGFR.

“These results should motivate enhanced attention to venous thromboembolism prophylaxis in the CKD population, particularly among those with more advanced categories of CKD,” Dr Surapaneni’s team concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.