Pulmonary vascular disease & thromboembolismResearch article
Venous Thromboembolism in Severe Renal Insufficiency
- Registro Informatizado de Enfermedad TromboEmbólica (2005-2024) analysis
Authors' conclusion
Patients with VTE and severe renal insufficiency are elderly, medically complex, and experience high short-term mortality. The relative balance between fatal PE and fatal bleeding changes over time, with fatal PE predominating early and fatal bleeding thereafter, while real-world management frequently differs from product labels and guideline recommendations.
Study context
- Population
- Patients with acute venous thromboembolism (VTE) and creatinine clearance < 30 mL/minpatients with acute VTE and creatinine clearance < 30 mL/min enrolled in the registry
- Participants
- 5,763 patients
Main finding
As reported in the abstract
Baseline characteristics
- Mean age
- 81 years
- Women
- 69%
- Presented with pulmonary embolism (PE)
- 56%
- Creatinine clearance <15 mL/min
- 16%
- Receiving hemodialysis
- 3.6%
Further findings
Temporal trends · 4 calendar periods
- Severe renal dysfunction and hemodialysis became more frequent over time
- Initial treatment remained predominantly low-molecular-weight heparin; vitamin K antagonist use declined and direct oral anticoagulant use increased
Recurrent VTE and death · 90 days
- Recurrent VTE
- 1.3%
- Died
- 20%
Fatal PE
- First 10 days
- 2.0%
- Days 11 to 90
- 0.3%
Safety
Major bleeding · 90 days
- Major bleeding
- 5.1%
Fatal bleeding
- First 10 days
- 0.3%
- Days 11 to 90
- 0.7%
- During the first 10 days fatal PE exceeded fatal bleeding; during days 11 to 90 fatal bleeding exceeded fatal PE
Original publication
Venous Thromboembolism in Severe Renal Insufficiency. JACC Adv. Published 23 September 2026. doi:10.1016/j.jacadv.2026.103268
Summarised from the published abstract; every number is checked against it