Risk of VTE Increases with Microalbuminuria

Microalbuminuria is an independent risk factor for venous thromboembolism (VTE), reports a study in The Journal of the American Medical Association.

The investigators analyzed data on 8574 Dutch adults participating in a community cohort study. Microalbuminuria, defined as albumin level of 30 to 300 mg per 24-h urine collection, was assessed as a risk factor for deep vein thrombosis and/or pulmonary embolism. At an average follow-up of 8.6 years, the annual incidence of VTE was 0.14 percent.

As urinary albumin excretion (UAE) increased, so did the incidence of VTE: 0.12 percent at UAE under 15 mg/24 h, 0.20 percent at 15 to 29 mg/24 h, 0.40 percent at 30 to 300 mg/24 h, and 0.56 percent at more than 300 mg/24 h. On adjusted analysis, hazard ratios for VTE at the different levels of UAE were 1.40 at 15 to 29 mg/24 h, 2.20 at 30 to 300 mg/24 h, and 2.82 at more than 300 mg/24 h. The hazard ratio for VTE among patients with microalbuminuria was 2.00. One additional case of VTE would occur each year for each 388 people with microalbuminuria.

The results suggest that microalbuminuria is associated not only with arterial thromboembolism, but also with VTE. Risk of VTE increases at higher UAE levels, even short of microalbuminuria. More study will be needed to determine whether treatment for microalbuminuria can influence VTE risk [Mahmoodi BKJ, Gansevoort RT, Veeger NJGM, Matthews AG, Navis G, Hillege HL, van der Meer J, for the Prevention of Renal and Vascular End-stage Disease (PREVEND) Study Group. J Am Med Assoc 2009; 301:1790–1797].