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Deep vein thrombosis in patients with chronic kidney disease.

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.

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  • Authors+Show Affiliations

    ,

    Cardiovascular Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

    , ,

    Source

    Thrombosis and haemostasis 99:6 2008 Jun pg 1035-9

    MeSH

    Adult
    African Americans
    Age Factors
    Aged
    Aged, 80 and over
    Cross-Sectional Studies
    Fibrinolytic Agents
    Heart Failure
    Hispanic Americans
    Humans
    Kidney Failure, Chronic
    Middle Aged
    Nephrotic Syndrome
    Odds Ratio
    Prospective Studies
    Registries
    Renal Dialysis
    Risk Assessment
    Risk Factors
    Surgical Procedures, Operative
    Ultrasonography
    United States
    Venous Thrombosis

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    18521505

    Citation

    Daneschvar, H Leon, et al. "Deep Vein Thrombosis in Patients With Chronic Kidney Disease." Thrombosis and Haemostasis, vol. 99, no. 6, 2008, pp. 1035-9.
    Daneschvar HL, Seddighzadeh A, Piazza G, et al. Deep vein thrombosis in patients with chronic kidney disease. Thromb Haemost. 2008;99(6):1035-9.
    Daneschvar, H. L., Seddighzadeh, A., Piazza, G., & Goldhaber, S. Z. (2008). Deep vein thrombosis in patients with chronic kidney disease. Thrombosis and Haemostasis, 99(6), pp. 1035-9. doi:10.1160/TH08-02-0107.
    Daneschvar HL, et al. Deep Vein Thrombosis in Patients With Chronic Kidney Disease. Thromb Haemost. 2008;99(6):1035-9. PubMed PMID: 18521505.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Deep vein thrombosis in patients with chronic kidney disease. AU - Daneschvar,H Leon, AU - Seddighzadeh,Ali, AU - Piazza,Gregory, AU - Goldhaber,Samuel Z, PY - 2008/6/4/pubmed PY - 2008/8/5/medline PY - 2008/6/4/entrez SP - 1035 EP - 9 JF - Thrombosis and haemostasis JO - Thromb. Haemost. VL - 99 IS - 6 N2 - 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. SN - 0340-6245 UR - https://www.unboundmedicine.com/medline/citation/18521505/Deep_vein_thrombosis_in_patients_with_chronic_kidney_disease_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1160/TH08-02-0107 DB - PRIME DP - Unbound Medicine ER -