Risk factors for venous thromboembolism in patients with chronic kidney disease: a systematic review and meta-analysis

The objective of this study was to conduct a meta-analysis and systematic review to identify the risk factors contributing to thromboembolism (VTE) in chronic kidney disease (CKD) patients. PubMed, Cochrane Library, Web of Science, and Embase databases were searched from inception to October 2024. Cohort, case-control, and cross-sectional studies examining risk factors for VTE in CKD were included. Quality assessment and data extraction were conducted. Fourteen studies were analyzed. CKD stage 2 (OR: 1.15, 95% CI: 1.06–1.25, <i>p</i> &lt; .01), CKD stage 3 (OR: 2.28, 95% CI: 1.76–2.95, <i>p</i> &lt; .01), CKD stage 3–4 (OR: 1.57, 95% CI: 1.17–2.1, <i>p</i> &lt; .01), end-stage renal disease (OR: 3.68, 95% CI: 1.02–13.27, <i>p</i> &lt; .01), female (OR: 1.30, 95% CI: 1.15–1.48, <i>p</i> &lt; .01), congestive heart failure (CHF) (OR: 1.26, 95% CI: 1.09–1.46, <i>p</i> &lt; .01), atrial fibrillation (AF) (OR: 1.97, 95% CI: 1.40–2.97, <i>p</i> &lt; .01), coronary artery disease (CAD) (OR: 1.28, 95% CI: 1.05–1.56, <i>p</i> = .01), and systemic lupus erythematosus (SLE) (OR: 3.06, 95% CI: 1.57–5.94, <i>p</i> &lt; .01) were associated with increased risk of VTE. In addition, in sensitivity analyses, hemodialysis increased the risk of VTE compared with peritoneal dialysis (OR: 2.35, 95% CI: 1.34–4.14, <i>p</i> &lt; .01). Different CKD stages, female, CHF, AF, CAD, and SLE emerge as significant risk factors for VTE in CKD patients. Additionally, VTE risk can be influenced by dialysis modality and other factors. Physicians should comprehensively assess the risk of VTE in patients with CKD.