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Background Recent findings suggest that chronic kidney disease(CKD)may be associated with increased risk of venous thromboembolism(VTE).Given the high prevalence of mild-to-moderate CKD in the general population,in depth analysis of this association is warranted.Methods and Results We pooled individual participant data from five community-based cohorts from Europe(HUNT2,PREVEND and Troms? study)and United States(ARIC and CHS study)to assess the association of estimated glomerular filtration rate(eGFR),albuminuria and CKD with objectively verified VTE.To estimate adjusted hazard ratios(HRs)for VTE,categorical and continuous spline models were fit using Cox regression with shared-frailty or random-effect meta-analysis.A total of 1,178 VTE events occurred over 599,453 personyears follow-up.Relative to eGFR 100 mL / min / 1.73 m 2,HRs for VTE were 1.29(95%CI,1.04-1.59)for eGFR 75,1.31(1.00-1.71)for 60,1.82(1.27-2.60)for 45 and 1.95(1.26-3.01)for 30 mL / min / 1.73 m 2.Compared with albumin-creatinine ratio(ACR)of 5.0 mg / g,the HRs for VTE were 1.34(1.04-1.72)for 30 mg / g,1.60(1.08-2.36)for 300 mg / g and 1.92(1.19-3.09)for 1000 mg / g.There was no interaction between clinical categories of eGFR and ACR(P = 0.20).The adjusted HR for CKD defined as eGFR < 60 mL / min / 1.73 m 2 or albuminuria ≥30 mg / g(vs.no CKD)was 1.54(95%CI,1.15-2.06).Associations were consistent in subgroups according to age,gender,and comorbidities as well as for unprovoked versus provoked VTE.Conclusions Both eGFR and ACR are independently associated with increased risk of VTE in the general population,even across the normal eGFR and ACR ranges.
Background Recent findings suggest that chronic kidney disease (CKD) may be associated with increased risk of venous thromboembolism (VTE). Giving the high prevalence of mild-to-moderate CKD in the general population, in depth analysis of this association is warranted. Methods and Results We pooled individual participant data from five community-based cohorts from Europe (HUNT2, PREVEND and Troms? study) and United States (ARIC and CHS study) to assess the association of estimated glomerular filtration rate (eGFR), albuminuria and CKD with objectively verified VTE.To estimate adjusted hazard ratios (HRs) for VTE, categorical and continuous spline models were fit using Cox regression with shared-frailty or random-effect meta-analysis. A total of 1,178 VTE events occurred over 599,453 personyears follow-up HRE for VTE were 1.29 (95% CI, 1.04-1.59) for eGFR 75, 1.31 (1.00-1.71) for 60, 1.82 (1.27-2.60) for 45 and 1.95 (1.26-3.01) for 30 mL / min / 1.73 m 2.Compared with albumin The HRs for VTE were 1.34 (1.04-1.72) for 30 mg / g, 1.60 (1.08-2.36) for 300 mg / g and 1.92 (1.19-3.09) for 1000 mg / g. There was no interaction between clinical categories of eGFR and ACR (P = 0.20). The adjusted HR for CKD defined as eGFR <60 mL / min / 1.73 m 2 or albuminuria ≥ 30 mg / g (vs. no CKD) was 1.54 (95% CI, 1.15-2.06). Associations were consistent in subgroups according to age, gender, and comorbidities as well as for unprovoked versus provoked VTE. Conclusions Both eGFR and ACR are independently associated with increased risk of VTE in the general population, even across the normal eGFR and ACR ranges.