关键词: 慢性肾脏病, 静脉血栓栓塞, 临床特征, 预后

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the clinical characteristics and outcomes of chronic kidney disease patients with concomitant venous thromboembolism.
Ｍｅｔｈｏｄｏｌｏｇｙ：We retrospectively analyzed the clinical characteristics and outcomes of patients with CKD and VTE between January 2012 and May 2021 from the National Clinical Research Center of Kidney Diseases.
Ｒｅｓｕｌｔｓ：A total of 682 CKD patients were confirmed with VTE, of which 521 (76.4％) were male and 420 (61.6％) had VTE occurring 6 months before the onset of CKD.617 cases (90.5％) were in the state of nephrotic syndrome (NS), with the most common being membranous nephropathy (MN) in 372 cases (54.5％). The most common VTE was pulmonary embolism (PE) in 474 cases (69.5％), followed by renal vein embolism (RVT) in 337 cases (49.4％), and lower limb vein embolism (DVT) in 101 cases (14.8％); some patients had multiple site embolisms simultaneously, with PE+RVT being the most common (196 cases, accounting for 28.7％). 405 patients (59.4％) had no clinical symptoms, with 82.2％ (277/337) and 66.7％ (316/474) of RVT and PE patients having no symptoms, respectively. The positive rate of D-dimer in laboratory tests was 91.9％ (564/614). During a 2-year follow-up, 62 patients (9.1％) experienced VTE recurrence, and 55 patients (8.1％) experienced bleeding events during anticoagulant therapy and reduced or discontinued anticoagulants. A total of 60 bleeding events occurred, of which only 1 was a clinical major bleeding event.
Ｃｏｎｃｌｕｓｉｏｎ：VTE in CKD patients often occurs within 6 months of the disease course, especially in males. The vast majority of patients present with nephrotic syndrome, but more than half of them do not have corresponding clinical symptoms, which may underestimate the occurrence of PE and RVT. After anticoagulant treatment, the recurrence rate of VTE patients is low, and major bleeding complications are not common.

Key words: chronic kidney disease, venous thromboembolism, clinical characteristicsprognosis