Chronic kidney disease is associated with increased risk of venous thromboembolism recurrence

Introduction It is currently unclear whether chronic kidney disease (CKD) and the decrease in renal function can influence the risk of venous thromboembolism (VTE) recurrence. Materials and methods We performed an ambispective observational study on 409 patients with a previous episode of VTE. All the patients were included in the retrospective analysis whereas a subgroup of 260 individuals, without history of recurrence and that stopped oral anticoagulation, were then followed-up for a mean of 52.3 ± 20.7 months. Results At the enrollment, subjects with history of recurrent VTE were prevalently male with higher blood pressure and lower eGFR. Prevalence of CKD (defined as eGFR < 60 ml/min/1.73 m2) was higher in patients with previous VTE recurrence with an adjusted OR of 5.69 (IC95% 2.17–14.90, p < 0.001) compared to patients with normal eGFR. Similar findings were obtained from the prospective study where an adjusted 5.32 HR for VTE recurrence was seen in patients with CKD compared to subjects with normal renal function (IC95% 1.49–18.95, p = 0.010). An increase in the risk of recurrent VTE was also observed in patients with mild decrease in renal function (eGFR 60–90 vs ≥ 90 ml/min/1.73 m2 adjusted HR 2.84, IC95% 1.13–7.11, p = 0.025). Moreover, a multivariate Cox regression analysis including eGFR as continuous variable showed that renal function decrease was independently associated with the risk of VTE recurrence (p = 0.001). Conclusions CKD and mild decrease in renal function are associated with a significant increase in the risk of recurrent VTE. © 2017 Elsevier Ltd