Deep vein thrombosis in patients with chronic kidney disease

Thromb Haemost. 2008 Jun;99(6):1035-9. doi: 10.1160/TH08-02-0107.

Abstract

Deep vein thrombosis (DVT) is a poorly understood complication of chronic kidney disease (CKD). The objective of our analysis was to profile DVT patients with and without CKD. We defined CKD as patients requiring dialysis or patients having nephrotic syndrome. We compared 268 patients with CKD (184 patients with dialysis-dependent renal disease and 84 with nephrotic syndrome) to 4,307 patients with preserved renal function from a prospective United States multicenter deep venous thrombosis (DVT) registry. Compared with non-CKD patients, CKD patients with DVT were younger (median age 62 vs. 69 years, p < 0.0001), more often African-American (p < 0.0001), and more often Hispanic (p = 0.0003). CKD patients underwent surgery more frequently in the three months prior to developing DVT (48.9% vs. 39.0%, p = 0.001) and more often had concomitant congestive heart failure (20.9% vs. 14.6%, p = 0.005). CKD patients suffered upper extremity DVT more frequently (30.0% vs. 10.8%, p < 0.0001). Patients with CKD presented less often with typical DVT symptoms of extremity discomfort (42.9% vs. 52.4%, p = 0.003) and difficulty ambulating (5.4% vs. 10.1%, p = 0.01). Prophylaxis rates prior to DVT were similarly low in CKD and non-CKD patients (44.2% vs. 38.0%, p = 0.06). Future studies of DVT in CKD patients should explore novel strategies for improving prophylaxis utilization and the detection of DVT in this special population.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data
  • Cross-Sectional Studies
  • Fibrinolytic Agents / therapeutic use
  • Heart Failure / complications
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / ethnology
  • Kidney Failure, Chronic / therapy
  • Middle Aged
  • Nephrotic Syndrome / complications*
  • Nephrotic Syndrome / ethnology
  • Odds Ratio
  • Prospective Studies
  • Registries
  • Renal Dialysis
  • Risk Assessment
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects
  • Ultrasonography
  • United States
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / ethnology
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / prevention & control

Substances

  • Fibrinolytic Agents