Kidney Week

Abstract: SA-PO1121

Association Between CKD and Venous Thromboembolism Post-Hospitalization

Session Information

• CKD Epidemiology, Risk Factors, Prevention - III
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Zheng, Zhong, NYU Langone Health, New York, New York, United States

Zhong Zheng,

• Pandit, Krutika, NYU Langone Health, New York, New York, United States

Krutika Pandit,

• Chang, Alexander R., Geisinger Health, Danville, Pennsylvania, United States

Alexander R. Chang,

• Shin, Jung-Im, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States

Jung-Im Shin,

• Charytan, David M., NYU Langone Health, New York, New York, United States

David M. Charytan,

• Grams, Morgan, NYU Langone Health, New York, New York, United States

Morgan Grams,

• Surapaneni, Aditya L., NYU Langone Health, New York, New York, United States

Aditya L. Surapaneni,

Background

Chronic kidney disease (CKD) has been implicated as a risk factor for venous thromboembolism (VTE), but the evidence is limited to relatively healthy populations. The objective of the current study is to discern whether parameters of kidney function and damage are associated with the occurrence of VTE after hospitalization.

Methods

We conducted a retrospective study including 24,048 and 11,737 adult individuals hospitalized within Geisinger Health and NYU Langone Health from 2004 to 2019 and 2012 to 2022, respectively. A Poisson model was used to evaluate adjusted incidence rates of post-hospitalization VTE according to estimated glomerular filtration rate (eGFR) and albuminuria stages of CKD in each cohort. Cox proportional hazards models were used to analyze associations of eGFR and urine albumin to creatinine ratio (ACR) with VTE.

Results

In the Geisinger cohort, the incidence of VTE after hospital discharge increased from 10.7 (95% CI 9.2 – 12.6) events per 1000 person-years in individuals in G1A1 (eGFR>90 mL/min/1.73 m² and ACR <30 mg/g) to 27.7 (95% CI 20.7 – 37.3) events per 1000 person-years in individuals with G4-5A3 (eGFR<30 mL/min/1.73 m² and ACR >300 mg/g), with similar findings in the NYU cohort. Meta-analysis of the two cohorts showed that every 10 mL/min/1.73m² reduction in eGFR below 60 mL/min/1.73m² and each two-fold increase in ACR were associated with a higher risk of VTE (HR 1.08, 95% CI [1.02 – 1.15] and HR 1.05, 95% CI [1.03 - 1.08]) respectively.

Conclusion

Both eGFR and ACR are independently associated with increased risk of VTE after hospitalization. The incidence rate increases with the severity of CKD. This suggests the potential need for targeted strategies of VTE prophylaxis after hospitalization in individuals with CKD.

Funding

• Other NIH Support