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Thromb Res. 2018 Oct;170:10-19. doi: 10.1016/j.thromres.2018.07.029. Epub 2018 Jul 31.

Venous thromboembolism, factor VIII and chronic kidney disease.

Author information

1
Department of Medicine, Larner College of Medicine, at the University of Vermont, 1 South Prospect Street, 2309 UHC Med-Nephrology, Burlington, VT 05401, United States. Electronic address: klcheung@med.uvm.edu.
2
Department of Biochemistry, Larner College of Medicine, at the University of Vermont, 89 Beaumont Avenue, Given C440A, Burlington, VT 05401, United States. Electronic address: beth.bouchard@uvm.edu.
3
Department of Medicine, Larner College of Medicine, at the University of Vermont, 1 South Prospect Street, 2309 UHC Med-Nephrology, Burlington, VT 05401, United States; Department of Pathology and Laboratory Medicine, Larner College of Medicine, at the University of Vermont, 360 South Park Drive, Colchester Research Facility 206D, Colchester, VT 05446, United States. Electronic address: mary.cushman@med.uvm.edu.

Abstract

Chronic kidney disease (CKD) affects 30 million Americans and is associated with approximately a two-fold increased risk of venous thromboembolism (VTE). There is a graded increased risk of VTE across declining kidney function, as measured by estimated glomerular filtration rate (eGFR) and albuminuria. When patients with end-stage kidney disease (ESKD) experience VTE they are more likely than the general population to be hospitalized and they have a higher mortality. The incidence and consequences of VTE may also differ depending on the cause of kidney disease. In addition, kidney transplant patients with VTE are at a greater risk for death and graft loss than transplant patients without VTE. The reasons that patients with CKD are at increased risk of VTE are not well understood, but recent data suggest that factor VIII is a mediator. Factor VIII is an essential cofactor in the coagulation cascade and a strong risk factor for VTE in general. It is inversely correlated with eGFR and prospective studies demonstrate that factor VIII activity predicts incident CKD and rapid eGFR decline. The etiology of CKD may also influence factor VIII levels. This review summarizes the epidemiology VTE in CKD and reviews the biochemistry of factor VIII and determinants of its levels, including von Willebrand factor and ABO blood group. We explore mechanisms by which the complications of CKD might give rise to higher factor VIII and suggests future research directions to understand how factor VIII and CKD are linked.

KEYWORDS:

ABO blood-group system; Factor VIII; Kidney diseases; Venous thromboembolism; von Willebrand factor

PMID:
30081388
DOI:
10.1016/j.thromres.2018.07.029
[Indexed for MEDLINE]

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