Dialysis patients are at increased risk of venous thromboembolism (VTE), and the condition is associated with a greater likelihood of bleeding and all-cause mortality, Canadian researchers reported.
In a population-based retrospective cohort study, researchers compared 13,315 adult incident dialysis patients who were matched by age and sex to 53,260 individuals in the general population. VTE developed in 1114 (8.4%) of the dialysis patients in the 3 years following dialysis initiation, according to a paper published online in Nephrology Dialysis Transplantation. Patients were at greatest risk for VTE within the 6 months following dialysis initiation. By comparison, VTE developed in 1233 (2.3%) individuals in the general population. Dialysis patients had a 2.9-fold increased risk of VTE compared with the general population in adjusted analyses. Both components of VTE developed more frequently in dialysis patients.
In adjusted analyses, dialysis patients with VTE had a 2.0-fold and 2.4-fold higher risk of bleeding and all-cause mortality, respectively, compared with those who did not have VTE.
They found that patients whose initial dialysis modality was peritoneal dialysis (PD) versus hemodialysis (HD) had a 29% lower risk of VTE. In addition, VTE risk was higher among patients using a central venous catheter than those who had an arteriovenous fistula or graft or who were on PD.
Of the 1114 dialysis patients who experienced VTE, 192 (17.2%) had a recurrent event more than 1 year following the initial VTE. Compared with dialysis patients who did not have a VTE, those who did had a 2.0- and 2.4-fold greater risk of major bleeding and all-cause mortality, respectively.