Katharine L Cheung1, Neil A Zakai2, Aaron R Folsom3, Manjula Kurella Tamura4, Carmen A Peralta5, Suzanne E Judd6, Peter W Callas7, Mary Cushman2. 1. Larner College of Medicine, University of Vermont, Burlington, VT. Electronic address: klcheung@med.uvm.edu. 2. Larner College of Medicine, University of Vermont, Burlington, VT. 3. University of Minnesota, Minneapolis, MN. 4. Geriatrics Research Education and Clinical Center, Stanford University and VA Palo Alto Health Care System, Palo Alto, CA. 5. University of California San Francisco, San Francisco, CA. 6. University of Alabama-Birmingham, Birmingham, AL. 7. University of Vermont, Burlington, VT.
Abstract
BACKGROUND: Kidney disease has been associated with venous thromboembolism (VTE) risk, but results conflict and there is little information regarding blacks. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 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. PREDICTORS: Estimated glomerular filtration rate (eGFR) using the combined creatinine-cystatin C (eGFRcr-cys) equation and urinary albumin-creatinine ratio (ACR). OUTCOMES: 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-cys of 60 to <90, 45 to <60, and <45 versus ≥90mL/min/1.73m2 were 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. LIMITATIONS: 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.
BACKGROUND:Kidney disease has been associated with venous thromboembolism (VTE) risk, but results conflict and there is little information regarding blacks. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 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. PREDICTORS: Estimated glomerular filtration rate (eGFR) using the combined creatinine-cystatin C (eGFRcr-cys) equation and urinary albumin-creatinine ratio (ACR). OUTCOMES: 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-cys of 60 to <90, 45 to <60, and <45 versus ≥90mL/min/1.73m2 were 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. LIMITATIONS: 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: Jewell H Halanych; Faisal Shuaib; Gaurav Parmar; Rajasekhar Tanikella; Virginia J Howard; David L Roth; Ronald J Prineas; Monika M Safford Journal: Am J Epidemiol Date: 2011-05-03 Impact factor: 4.897
Authors: Naji Younes; Patricia A Cleary; Michael W Steffes; Ian H de Boer; Mark E Molitch; Brandy N Rutledge; John M Lachin; William Dahms Journal: Clin J Am Soc Nephrol Date: 2010-05-06 Impact factor: 8.237
Authors: Virginia J Howard; Mary Cushman; Leavonne Pulley; Camilo R Gomez; Rodney C Go; Ronald J Prineas; Andra Graham; Claudia S Moy; George Howard Journal: Neuroepidemiology Date: 2005-06-29 Impact factor: 3.282
Authors: Sarah R Gillett; Rebekah H Boyle; Neil A Zakai; Leslie A McClure; Nancy S Jenny; Mary Cushman Journal: Clin Biochem Date: 2014-08-14 Impact factor: 3.281
Authors: Lesley A Inker; Christopher H Schmid; Hocine Tighiouart; John H Eckfeldt; Harold I Feldman; Tom Greene; John W Kusek; Jane Manzi; Frederick Van Lente; Yaping Lucy Zhang; Josef Coresh; Andrew S Levey Journal: N Engl J Med Date: 2012-07-05 Impact factor: 91.245
Authors: Manjula Kurella Tamura; Virginia Wadley; Kristine Yaffe; Leslie A McClure; George Howard; Rodney Go; Richard M Allman; David G Warnock; William McClellan Journal: Am J Kidney Dis Date: 2008-06-30 Impact factor: 8.860
Authors: Bakhtawar K Mahmoodi; Ron T Gansevoort; Nic J G M Veeger; Abigail G Matthews; Gerjan Navis; Hans L Hillege; Jan van der Meer Journal: JAMA Date: 2009-05-06 Impact factor: 56.272
Authors: Melissa C Caughey; Vimal K Derebail; Nigel S Key; Alexander P Reiner; Rebecca F Gottesman; Abhijit V Kshirsagar; Gerardo Heiss Journal: Am J Hematol Date: 2019-09-10 Impact factor: 10.047
Authors: K L Cheung; N A Zakai; P W Callas; G Howard; B K Mahmoodi; C A Peralta; S E Judd; M Kurella Tamura; M Cushman Journal: J Thromb Haemost Date: 2018-08-09 Impact factor: 5.824
Authors: Rachel Jeong; Robert R Quinn; Pietro Ravani; Feng Ye; Manish M Sood; David Massicotte-Azarniouch; Marcello Tonelli; Brenda R Hemmelgarn; Ngan N Lam Journal: Can J Kidney Health Dis Date: 2020-10-08
Authors: Anja Gäckler; Hana Rohn; Ton Lisman; Tamas Benkö; Oliver Witzke; Andreas Kribben; Fuat H Saner Journal: PLoS One Date: 2019-02-20 Impact factor: 3.240
Authors: Joanna Rupa-Matysek; Marta Lembicz; Eliza Katarzyna Rogowska; Lidia Gil; Mieczysław Komarnicki; Halina Batura-Gabryel Journal: Med Oncol Date: 2018-04-03 Impact factor: 3.064