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Updated: Jun 8, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Chronic kidney disease stages 1-3 increase the risk of venous thrombosis
G Ocak1, M Verduijn, C Y Vossen
1Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
Insights
Early-stage chronic kidney disease (CKD) increases venous thrombosis (VT) risk, particularly with albuminuria. Albuminuria is a stronger predictor of VT risk than reduced kidney function in CKD patients.
Area of Science:
- Nephrology
- Vascular Medicine
- Epidemiology
Background:
- End-stage renal disease is linked to venous thrombosis (VT).
- The risk of VT in early stages of chronic kidney disease (CKD) remains understudied.
- This study investigates VT risk in CKD stages 1-3.
Purpose of the Study:
- To determine if patients with early-stage CKD (stages 1-3) have an elevated risk of venous thrombosis.
- To explore the relationship between CKD stage, albuminuria, glomerular filtration rate, and VT risk.
Main Methods:
- Prospective cohort study of 8,495 subjects followed for VT occurrence over 10 years.
- CKD staging based on Kidney Disease Outcomes Quality Initiative guidelines (albuminuria and estimated glomerular filtration rate).
- Objectively verified symptomatic VT served as the primary endpoint.
Main Results:
- 128 individuals developed VT during a median 9.2-year follow-up.
- Adjusted hazard ratios for VT were 2.2 (CKD 1), 1.9 (CKD 2), and 1.6 (CKD 3) compared to non-CKD.
- CKD stage 3 with albuminuria showed a significantly higher VT risk (adjusted HR 3.0) than CKD stage 3 without albuminuria (adjusted HR 1.0).
Conclusions:
- CKD stages 1 and 2 are associated with increased VT risk.
- CKD stage 3 with albuminuria is a significant risk factor for VT.
- Albuminuria is a more critical determinant of VT risk in CKD than reduced glomerular filtration rate.
Background:
End-stage renal disease has been associated with venous thrombosis (VT). However, the risk of VT in the early stages of chronic kidney disease (CKD) has not yet been investigated. The aim of this study was to investigate whether CKD patients with stage 1-3 disease are at increased risk of VT.
Methods:
Eight thousand four hundred and ninety-five subjects were included in a prospective cohort study, in which renal function and albuminuria were assessed, starting in 1997-1998, and were followed for the occurrence of VT until 1 June 2007. CKD patients were staged according to the Kidney Disease Outcomes Quality Initiative guidelines, on the basis of 24-h urine albumin excretion and estimated glomerular filtration rates. Objectively verified symptomatic VT was considered to be the endpoint.
Results:
Of the 8495 subjects, 243 had CKD stage 1, 856 CKD stage 2, and 491 CKD stage 3. During a median follow-up period of 9.2 years, 128 individuals developed VT. The hazard ratios (HRs) for CKD stages 1, 2 and 3 were, respectively, 2.2 [95% confidence interval (CI) 0.9-5.1], 1.9 (95% CI 1.1-3.1) and 1.6 (95% CI 0.9-2.8) relative to those without CKD after adjustment for age, sex, body mass index, hypertension, diabetes, malignancy, and high-sensitivity C-reactive protein. Subjects with CKD stage 3 and albuminuria (≥ 30 mg d(-1)) had an adjusted HR of 3.0, and subjects with CKD stage 3 without albuminuria had an adjusted HR of 1.0.
Conclusions:
CKD stages 1 and 2, and CKD stage 3 in the presence of albuminuria, are risk factors for VT. The risk of VT is more related to albuminuria than to impaired glomerular filtration rate.
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