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. 2018 Aug 16;19(1):204.
doi: 10.1186/s12882-018-0989-z.

Increased risk of deep vein thrombosis in end-stage renal disease patients

Hsueh-Yi Lu  1 , Kuang-Ming Liao  2
Affiliations

Increased risk of deep vein thrombosis in end-stage renal disease patients

Hsueh-Yi Lu et al. BMC Nephrol. .

Abstract

Background: Previous studies have shown that chronic kidney disease increases the risk of deep vein thrombosis (DVT). DVT is the risk of pulmonary embolism among persons with end-stage renal disease (ESRD). Information on the incidence of DVT in ESRD is limited, and no studies have been conducted in the Asian population. The aim of our study was to investigate the incidence of DVT in Asian ESRD patients by comparing with the non-ESRD patients and to identify the associated risk factors.

Methods: This study retrieved patients who were diagnosed with ESRD (ICD-9-CM codes 585 or 586) between January 1, 2004, and December 31, 2010, from the National Health Insurance Research Database in Taiwan. All ESRD patients had received a catastrophic illness card from the Ministry of Health and Welfare in Taiwan, with the major illness identified as ESRD. Patients who had DVT before the index date or who had incomplete records were excluded from the analysis. A total of 4865 ESRD patients were enrolled. There are 3564 ESRD patients included after exclusion of patients with previous DVT and patients with incomplete records. The control subjects were randomly selected as the patients without ESRD by matching study subjects according to age (±3 years), gender, and the year of admission at a 2:1 ratio from the same dataset.

Results: The incidence rate of DVT was substantially higher in the ESRD group than in the without-ESRD group (20.9 vs. 1.46 per 10^4 person-years). The adjusted hazard ratio (aHR 13.92; 95% CI 9.25-20.95) of DVT for the ESRD patients was 13.92 times that for the non-ESRD patients. ESRD patients older than 50 years had a higher risk of DVT (aHR 1.65; 95% CI 1.13-2.40; P = 0.01). Hyperlipidemia was significantly associated with an increased risk of DVT (aHR 1.73; 95% CI 1.08-2.78; P = 0.02). ESRD patients with three or more comorbidities were substantially more likely to have DVT (aHR 1.45; 95% CI 1.03-2.03; P = 0.03).

Conclusions: ESRD patients had a higher risk of DVT than non-ESRD patients. Among the ESRD patients, being older than 50 years and having dyslipidemia increased the risk of DVT.

Keywords: Deep vein thrombosis; End-stage renal disease; Incidence.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board (IRB) of the Chi Mei Medical Center, Taiwan (10609-E02).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of subject enrollment
Fig. 2
Fig. 2
Cumulative incidence function of DVT in patients with and without ESRD
Fig. 3
Fig. 3
Cumulative incidence function of DVT in patients with hyperlipidemia
Fig. 4
Fig. 4
Cumulative incidence function of DVT for patients aged over 50 years
Fig. 5
Fig. 5
Cumulative incidence function of DVT for patients with three or more comorbidities
See this image and copyright information in PMC

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