Abstract: FR-PO514

The Risk of Venous Thromboembolism in Patients with Albuminuria and Normal or Reduced Kidney Function

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Massicotte-Azarniouch, David, None, Ottawa, Ontario, Canada
  • Wald, Ron, St. Michael's Hospital, Toronto, Ontario, Canada
  • Sood, Manish M., Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • Bader eddeen, Anan, Istitution for Clinical Evaluative Sciences, Ottawa, Ontario, Canada
  • Lazo-Langner, Alejandro, Western University, London, Ontario, Canada
  • Molnar, Amber O., McMaster University, Hamilton, Ontario, Canada
  • Lam, Ngan, University of Alberta, Edmonton, Alberta, Canada
  • Zimmerman, Deborah Lynn, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • Garg, Amit X., London Health Sciences Centre, London, Ontario, Canada
  • Harel, Ziv, None, Ottawa, Ontario, Canada
  • Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada
Background

Chronic kidney disease (CKD), defined by the presence of either albuminuria and/or reduced kidney function, is associated with a higher risk of venous thromboembolism (VTE). Whether the risk of VTE differs in CKD patients with albuminuria and normal or reduced kidney function remains unclear.

Methods

We conducted a retrospective population-based cohort study of 694, 956 patients in Ontario, Canada between 2002 and 2012. We included patients with a measurement of albuminuria (albumin-to-creatinine ratio, ACR) and serum creatinine (for estimated glomerular filtration rate, eGFR). The primary outcome was the time to a first VTE event examined across differing levels of albuminuria and kidney function using adjusted Cox proportional hazard models and accounting for the competing risk of death.

Results

A total of 15,180 (2.2%) VTE events occurred during the study period. Both albuminuria and kidney function were independently associated with VTE (p<0.0001). The association of albuminuria and VTE differed by the level of kidney function (ACR X eGFR interaction p=0.0001). The risk of VTE in patients with normal kidney function (eGFR 120 mL/min/1.73 m2) and heavy albuminuria (ACR 500 mg/g) was HR 2.39 (95% CI 2.01-2.83) compared to those with normal kidney function and no albuminuria. Among those with reduced kidney function (eGFR 30 mL/min/1.73 m2), the risk of VTE was increased, irrespective of albuminuria [ACR 0 vs. ACR 500 mg/g: HR 1.59 vs. 1.65).

Conclusion

Albuminuria increases the risk of VTE markedly in patient with normal kidney function but does not in those with reduced kidney function.

Adjusted hazard ratio of venous thromboembolism by albuminuria at fixed levels of kidney function

Funding

  • Government Support - Non-U.S.