title: Risk of venous thrombosis in patients with chronic kidney disease: identification of high-risk groups.
abstract: BACKGROUND
  Although an association between venous thrombosis and chronic kidney disease has recently been established, it is unknown which patients with chronic kidney disease are most likely to benefit from thromboprophylaxis.
  
  
  OBJECTIVE
  The aim of this study was to assess the association between venous thrombosis and chronic kidney disease in combination with arterial thrombosis, malignancy, surgery and thrombophilia to identify high-risk groups as a basis for personalized prevention.
  
  
  METHODS
  This study included 2473 consecutive patients with first venous thrombosis and 2936 controls from a case-control study (the MEGA study).
  
  
  RESULTS
  Moderately decreased kidney function (eGFR 30-60 mL min(-1) ) was associated with a 2.5-fold (95% CI, 1.9-3.4) increased risk and severely decreased kidney function (eGFR < 30 mL min(-1) ) was associated with a 5.5-fold (95% CI 1.8-16.7) increased risk of venous thrombosis, compared with those with normal kidney function (eGFR > 90 mL min(-1) ). The risk of venous thrombosis was additionally increased for moderately and severely reduced kidney function in combination with arterial thrombosis (odds ratio, 4.9; 95% CI, 2.2-10.9), malignancy (5.8; 95% CI, 2.8-12.1), surgery (14.0; 95%, CI 5.0-39.4), immobilization (17.1; 95% CI, 6.8-43.0) or thrombophilia (odds ratios, 4.3-9.5), with particularly high risks when three or more risk factors were present (odds ratio, 56.3; 95% CI, 7.6-419.3).
  
  
  CONCLUSIONS
  Decreased kidney function is associated with an increased risk of venous thrombosis. The risk increased substantially in the presence of one or more other risk factors for thrombosis.
authors: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors: G
authors: G
authors: Ocak
authors: W M
authors: WM
authors: Lijfering
authors: M
authors: M
authors: Verduijn
authors: F W
authors: FW
authors: Dekker
authors: F R
authors: FR
authors: Rosendaal
authors: S C
authors: SC
authors: Cannegieter
authors: C Y
authors: CY
authors: Vossen
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*