title: Prevalence of renal insufficiency in hospitalised patients with venous thromboembolic events: a retrospective analysis based on 6,725 VTE patients.
abstract: Renal impairment (RI) is an important factor in the selection of anticoagulant therapy in venous thromboembolic event (VTE) patients. In particular, the risk of bleeding events is higher for VTE patients with a glomerular filtration rate (GFR) below 30 mL/min. The aim of this study was to collect data on the prevalence of RI in hospitalised VTE patients in Germany. Furthermore, we investigated how renal function changed during inpatient treatment. We conducted a retrospective chart review in six German hospitals. All patients with a VTE diagnosis who were treated as inpatients from 2007-2011 were included. Patients were categorised according to their renal function. RI was estimated from serum creatinine values. Persistent RI was defined as an estimated glomerular filtration rate (eGFR) of <30 mL/min over at least 72 hours. Renal function could be determined for 5,710 VTE patients. Of these 21.4% had an eGFR>90 mL/min, 38.1% had an eGFR of 60-89 mL/min, 17.3% had an eGFR of 45-59 mL/min, 12.5% had an eGFR of 30-44 mL/min, 7.2% had an eGFR of 15-29 mL/min and 3.6% of the VTE patients had end-stage renal disease. Persistent severe RI was observed in 74.8% of patients with an eGFR <30 mL/min. Overall, 40.6% of the VTE patients investigated had an eGFR <60 mL/min; 10.8% had an eGFR <30 mL/min. Almost three quarters of RI-VTE patients suffered from persistent severe RI. These results suggest that more than one in ten VTE patients is exposed to a high risk of accumulating anticoagulants; most of these RI patients also face an increased risk of mortality.
authors.affiliation: Institute for Pharmacoeconomics and Medication Logistics, Philipp-Müller-Str. 12, Wismar, Germany. Electronic address: bjoern.boettger@ipam-wismar.de.
authors.forename: Björn
authors.initials: B
authors.lastname: Böttger
authors.affiliation: Clinical Pharmacology, Mannheim/Center for Gerontopharmacology, Medical Faculty Mannheim, University of Heidelberg, Maybachstr. 14, 68169, Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Wehling
authors.affiliation: Medical Department IV-Vascular Medicine, Max Ratschow Klinik, Klinikum Darmstadt GmbH, Grafenstr. 9, 64283 Darmstadt, Germany.
authors.forename: Rupert M
authors.initials: RM
authors.lastname: Bauersachs
authors.affiliation: Staedtisches Klinikum Muenchen GmbH, Krankenhausapotheke Schwabing, Koelner Platz 1, 80804 Muenchen, Deutschland, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Amann
authors.affiliation: Medizinische Klinik, Friedrich Ebert Krankenhaus, Friesenstraße 11, 24534 Neumuenster, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuchert
authors.affiliation: Klinik für Gefäßchirurgie und Angiologie, Kliniken Maria Hilf GmbH, Sandradstraße 43, 41061 Moenchengladbach, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Reinhold
authors.affiliation: Medizinische Klinik D - Allgemeine Innere Medizin sowie Nieren- und Hochdruckkrankheiten und Rheumatologie, Uniklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kümpers
authors.affiliation: Institute for Pharmacoeconomics and Medication Logistics, Philipp-Müller-Str. 12, Wismar, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wilke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000150:complications*
keywords: Epidemiology; Renal impairment; Venous thromboembolic event