title: Measures of Kidney Disease and the Risk of Venous Thromboembolism in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study.
abstract: BACKGROUND
  Kidney disease has been associated with venous thromboembolism (VTE) risk, but results conflict and there is little information regarding blacks.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  30,239 black and white adults 45 years or older enrolled in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study 2003 to 2007.
  
  
  METHODS
  Estimated glomerular filtration rate (eGFR) using the combined creatinine-cystatin C (eGFRcr-cys) equation and urinary albumin-creatinine ratio (ACR).
  
  
  RESULTS
  The primary outcome was adjudicated VTE, and secondary outcomes were provoked and unprovoked VTE, separately. Mortality was a competing-risk event.
  
  
  RESULTS
  During 4.6 years of follow-up, 239 incident VTE events occurred over 124,624 person-years. Cause-specific HRs of VTE were calculated using proportional hazards regression adjusted for age, sex, race, region of residence, and body mass index. Adjusted VTE HRs for eGFRcr-cysof 60 to <90, 45 to <60, and <45 versus ≥90mL/min/1.73m2were 1.28 (95% CI, 0.94-1.76), 1.30 (95% CI, 0.77-2.18), and 2.13 (95% CI, 1.21-3.76). Adjusted VTE HRs for ACR of 10 to <30, 30 to <300, and ≥300 versus <10mg/g were 1.14 (95% CI, 0.84-1.56), 1.15 (95% CI, 0.79-1.69), and 0.64 (95% CI, 0.25-1.62). Associations were similar for provoked and unprovoked VTE.
  
  
  CONCLUSIONS
  Single measurement of eGFR and ACR may have led to misclassification. Smaller numbers of events may have limited power.
  
  
  CONCLUSIONS
  There was an independent association of low eGFR (<45 vs ≥90mL/min/1.73m2) with VTE risk, but no association of ACR and VTE.
authors.affiliation: Larner College of Medicine, University of Vermont, Burlington, VT. Electronic address: klcheung@med.uvm.edu.
authors.forename: Katharine L
authors.initials: KL
authors.lastname: Cheung
authors.affiliation: Larner College of Medicine, University of Vermont, Burlington, VT.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Zakai
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.affiliation: Geriatrics Research Education and Clinical Center, Stanford University and VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Manjula
authors.initials: M
authors.lastname: Kurella Tamura
authors.affiliation: University of California San Francisco, San Francisco, CA.
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
authors.affiliation: University of Alabama-Birmingham, Birmingham, AL.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
authors.affiliation: University of Vermont, Burlington, VT.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Callas
authors.affiliation: Larner College of Medicine, University of Vermont, Burlington, VT.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D018570:Risk Assessment; D020521:Stroke / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000150:complications* / Q000453:epidemiology*; D044465:White People
keywords: Chronic kidney disease (CKD); albumin-creatinine ratio (ACR); albuminuria; deep vein thrombosis and pulmonary embolus; glomerular filtration rate (GFR); kidney disease measures; race; renal insufficiency; vascular disease; venous thromboembolism (VTE)