Estimated Glomerular Filtration Rate Decline is Causally Associated with Acute Pulmonary Embolism: A Nested Case–Control and Mendelian Randomization Study

Renal dysfunction is highly prevalent among patients with pulmonary embolism (PE). This study combined population-based study and Mendelian randomization (MR) to observe the relationship between renal function and PE.A nested case-control study were performed using data of PE patients and controls were from two nationwide cohorts, the China pUlmonary thromboembolism REgistry Study (CURES) and China Health and Retirement Longitudinal Survey (CHARLS). Baseline characteristics were balanced using propensity score matching and inverse probability of treatment weighting. Restricted cubic spline models were applied for the relationship between estimated glomerular filtration rate (eGFR) decline and the risk of PE. Bidirectional two-sample MR analyses were performed using genome-wide association study summary statistics for eGFR involving 1,201,909 individuals and for PE from the FinnGen consortium.The nested case-control study including 17,547 participants (6,322 PE patients) found that eGFR distribution was significantly different between PE patients and controls (<i>p</i> < 0.001), PE patients had a higher proportion of eGFR < 60 mL/min/1.73 m<sup>2</sup>. eGFR below 88 mL/min/1.73 m<sup>2</sup> was associated with a steep elevation in PE risk. MR analyses indicated a potential causal effect of eGFR decline on PE (odds ratio = 4·26, 95% confidence interval: 2·07-8·79), with no evidence of horizontal pleiotropy and reverse causality.Our findings support the hypothesis that renal function decline contributes to an elevated PE risk. Together with the high prevalence of chronic kidney diseases globally, there arises the necessity for monitoring and modulation of renal function in effective PE prevention.

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Publication Details

Journal
Thrombosis and Haemostasis
Published
2024-10-14
DOI
https://doi.org/10.1055/a-2439-5200
Primary Topic
Venous Thromboembolism Diagnosis and Management
Type
article
Field-Weighted Citation Impact
0.00

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article

Estimated Glomerular Filtration Rate Decline is Causally Associated with Acute Pulmonary Embolism: A Nested Case–Control and Mendelian Randomization Study

Feiya Xu, Xincheng Li, Zhiyong Guo, Peiran B Yang et al.
Thrombosis and Haemostasis
Venous Thromboembolism Diagnosis and Management
article

Estimated Glomerular Filtration Rate Decline is Causally Associated with Acute Pulmonary Embolism: A Nested Case–Control and Mendelian Randomization Study

Feiya Xu, Xincheng Li, Zhiyong Guo, Peiran B Yang, Yanshuang Lyu, Guohui Fan, Zhifa Han, Haoyi Weng, Huiyuan Hu, Xiaomeng Zhang, Chen Wang, Zhu Zhang, Hong Zhang, Yu Zhang, Haobo Li, Dingyi Wang, Xin Liu, Yinong Chen
article en

Abstract

Renal dysfunction is highly prevalent among patients with pulmonary embolism (PE). This study combined population-based study and Mendelian randomization (MR) to observe the relationship between renal function and PE.A nested case-control study were performed using data of PE patients and controls were from two nationwide cohorts, the China pUlmonary thromboembolism REgistry Study (CURES) and China Health and Retirement Longitudinal Survey (CHARLS). Baseline characteristics were balanced using propensity score matching and inverse probability of treatment weighting. Restricted cubic spline models were applied for the relationship between estimated glomerular filtration rate (eGFR) decline and the risk of PE. Bidirectional two-sample MR analyses were performed using genome-wide association study summary statistics for eGFR involving 1,201,909 individuals and for PE from the FinnGen consortium.The nested case-control study including 17,547 participants (6,322 PE patients) found that eGFR distribution was significantly different between PE patients and controls (<i>p</i> < 0.001), PE patients had a higher proportion of eGFR < 60 mL/min/1.73 m<sup>2</sup>. eGFR below 88 mL/min/1.73 m<sup>2</sup> was associated with a steep elevation in PE risk. MR analyses indicated a potential causal effect of eGFR decline on PE (odds ratio = 4·26, 95% confidence interval: 2·07-8·79), with no evidence of horizontal pleiotropy and reverse causality.Our findings support the hypothesis that renal function decline contributes to an elevated PE risk. Together with the high prevalence of chronic kidney diseases globally, there arises the necessity for monitoring and modulation of renal function in effective PE prevention.

Thrombosis and HaemostasisVol. 125(07)
Central South University (CN), Harbin Medical University (CN), Capital Medical University (CN), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Peking University (CN), China-Japan Friendship Hospital (CN), Peking Union Medical College Hospital (CN), Shenzhen Metro (China) (CN), Beijing Anzhen Hospital (CN), Beijing Hospital (CN), First Affiliated Hospital of Xi'an Jiaotong University (CN), Second Affiliated Hospital of Harbin Medical University (CN), Beijing Friendship Hospital (CN), Xi'an Jiaotong University (CN)
National Natural Science Foundation of China, Chinese Academy of Medical Sciences, National Key Research and Development Program of China, China-Japan Friendship Hospital, National Laboratory of Biomacromolecules
Good health and well-being
Openalex Percentile: Top 65%
Venous Thromboembolism Diagnosis and Management
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