Deep vein thrombosis in patients with chronic kidney disease

H. Leon Daneschvar; Ali Seddighzadeh; Gregory Piazza; Samuel Z. Goldhaber

doi:10.1160/TH08-02-0107

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 99(06): 1035-1039
DOI: 10.1160/TH08-02-0107

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Deep vein thrombosis in patients with chronic kidney disease

Authors

H. Leon Daneschvar

¹Cardiovascular Medicine Division, Department of Medicine, Brigham and Women’s Hospital; Harvard Medical School, Boston, Massachussetts, USA
Ali Seddighzadeh

¹Cardiovascular Medicine Division, Department of Medicine, Brigham and Women’s Hospital; Harvard Medical School, Boston, Massachussetts, USA
Gregory Piazza

²Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachussetts, USA
Samuel Z. Goldhaber

¹Cardiovascular Medicine Division, Department of Medicine, Brigham and Women’s Hospital; Harvard Medical School, Boston, Massachussetts, USA

Abstract

Summary

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.

Keywords

Chronic kidney disease - deep venous thrombosis - pulmonary embolism - prevention - renal failure - venous thromboembolism

Full Text

References

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