Chronic kidney disease – risk factor in venous thromboembolism

Introduction: Chronic renal disease (CKD) and low glomerular filtration rate are indicators of increased morbimortality in cardiovascular diseases. The asso-ciation between the incidence of venous thromboem-bolism (VTE) and chronic terminal renal disease or nephrotic syndrome is known.
Given this context, a question arises, little studied to date, whether CKD induces an unfavorable progression of VTE.
Methods: CKD presents common risk factors with atherosclerosis, mainly related to prothrombotic and proinflammatory status of renal disease, associating procoagulant status due to platelet dysfunction, activa-tion of coagulation, decreased fibrinolytic activity.
Results: The estimated risk of developing pulmonary thromboembolism, depending on the glomerular fil-tration rate, increases significantly from 88 ml/min /1.73m2, slightly more powerful for idiopathic TEV than secondary VTE. Long-term mortality was very high in patients with low clearance being similar to those seen generally in patients with heart failure. The prognostic ability of creatinine clearance in combina-tion with troponin for risk stratification revealed that patients with clearance below 35 ml/min/1.73m2, and positive myocardial marker markers had early morta-lity compared to subjects who had only one of these positive factors. These data call for awareness of the increased risk of adverse development of patients with pulmonary embolism and even mild forms of renal im-pairment.
Conclusions: Recognition of increased risk in this po-pulation is important for identifying appropriate treat-ment, especially in the presence of frequent comorbidi-ties such as atherosclerotic cardiovascular disease.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)