{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:18:20Z","timestamp":1787872700399,"version":"build-2784847793"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"09","funder":[{"name":"Austrian National Bank (Jubil\u00e4umsfond \u00d6sterreichische Nationalbank","award":["16433"],"award-info":[{"award-number":["16433"]}]},{"name":"Joseph-Skoda-Prize of the Austrian Association of Internal Medicine"},{"name":"Austrian Science Fund"},{"name":"Special Research Program (SFB) 54"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with end-stage kidney disease on hemodialysis (HD) have an increased risk of venous thromboembolism (VTE) and HD-specific vascular access thrombosis (VAT). We aimed to capture the incidence of VTE and VAT events and investigate risk factors for VTE and VAT occurrence, including antithrombotic agent use.<\/jats:p>\n                  <jats:p>Prevalent patients on maintenance HD were recruited into a prospective, population-based, observational cohort study in Vienna, Austria. During a maximum follow-up of 45 months, the occurrence of VTE, defined as deep vein thrombosis, catheter- or noncatheter-associated, and pulmonary embolism, or VAT, defined as thrombotic occlusion of an arteriovenous fistula or graft, was recorded. Risk factors for thrombotic events were analyzed by multivariable competing risk regression.<\/jats:p>\n                  <jats:p>VTE and VAT events occurred with an incidence rate of 1.7 (95% confidence interval [CI]: 1.2\u20132.6) and 7.6 per 100 person-years (95% CI: 6.3\u20139.3), respectively. The 30-day case fatality rates were 20.8 and 4.1% for VTE and VAT events, respectively. Prior VAT (hazard ratio [HR]: 3.07, 95% CI: 1.33\u20137.11, p\u2009=\u20090.009) and nephrectomy (HR: 6.53, 95% CI: 2.23\u201319.14, p\u2009=\u20090.001) were significantly associated with increased risk of VTE occurrence. Prior VAT was associated with a 1.8-fold (95% CI: 1.18\u20132.65, p\u2009=\u20090.006) and nephrectomy with a 2.8-fold increased risk of VAT occurrence (95% CI: 1.45\u20135.57, p\u2009=\u20090.002). Patients on vitamin K antagonists were protected from VTE (HR: 0.001, 95% CI: &lt;0.01\u2013\u2009&lt;\u20090.01, p\u2009&lt;\u20090.001) compared with nonusers but had no benefit with regard to VAT events.<\/jats:p>\n                  <jats:p>Identifying patients at high risk of thrombotic complications using risk factors, such as a history of nephrectomy and prior thrombotic events, may facilitate preventive measures.<\/jats:p>","DOI":"10.1055\/a-2700-6368","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T23:19:57Z","timestamp":1758755997000},"page":"965-973","source":"Crossref","is-referenced-by-count":0,"title":["Venous Thromboembolism and Vascular Access Thrombosis in Patients on Hemodialysis: Incidence, Risk Factors, and Use of Antithrombotic Agents"],"prefix":"10.1055","volume":"126","author":[{"given":"Oliver","family":"K\u00f6nigsbr\u00fcgge","sequence":"additional","affiliation":[{"name":"Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria"},{"name":"Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate","family":"Klauser-Braun","sequence":"additional","affiliation":[{"name":"Department of Medicine III, Clinic Donaustadt, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Schmaldienst","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Clinic Favoriten, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Vienna Dialysis Center, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Pabinger","sequence":"additional","affiliation":[{"name":"Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"S\u00e4emann","sequence":"additional","affiliation":[{"name":"Department of Medicine VI, Clinic Ottakring, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cihan","family":"Ay","sequence":"additional","affiliation":[{"name":"Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1681\/ASN.2007030308","article-title":"Chronic kidney disease increases risk for venous thromboembolism","volume":"19","author":"K Wattanakit","year":"2008","journal-title":"J Am Soc Nephrol"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1160\/TH11-06-0422","article-title":"Venous and arterial thrombosis in dialysis patients","volume":"106","author":"G Ocak","year":"2011","journal-title":"Thromb Haemost"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1093\/ndt\/gfx212","article-title":"Risk and complications of venous thromboembolism in dialysis patients","volume":"33","author":"A O Molnar","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1053\/j.ajkd.2019.12.001","article-title":"KDOQI Clinical practice guideline for vascular access: 2019 update","volume":"75","author":"C E Lok","year":"2020","journal-title":"Am J Kidney Dis"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.ejvs.2018.02.001","article-title":"Editor's choice - vascular access: 2018 clinical practice guidelines of the European Society for Vascular Surgery (ESVS)","volume":"55","author":"J Schmidli","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12959-022-00434-7","article-title":"Atrial fibrillation and anticoagulation are associated with hospitalisations in patients with end-stage kidney disease on haemodialysis: a prospective population-based cohort study","volume":"20","author":"D Steiner","year":"2022","journal-title":"Thromb J"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"100456","DOI":"10.1016\/j.xkme.2022.100456","article-title":"Hemodialysis vascular access and risk of major bleeding, thrombosis, and cardiovascular events: a cohort study","volume":"4","author":"N S Roetker","year":"2022","journal-title":"Kidney Med"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/j.jvs.2016.10.103","article-title":"A randomized controlled trial and cost-effectiveness analysis of early cannulation arteriovenous grafts versus tunneled central venous catheters in patients requiring urgent vascular access for hemodialysis","volume":"65","author":"E Aitken","year":"2017","journal-title":"J Vasc Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/1471-2261-13-86","article-title":"Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis","volume":"13","author":"P Napalkov","year":"2013","journal-title":"BMC Cardiovasc Disord"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jvs.2015.07.086","article-title":"Multiple preoperative and intraoperative factors predict early fistula thrombosis in the hemodialysis fistula maturation study","volume":"63","author":"A Farber","year":"2016","journal-title":"J Vasc Surg"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"e0169400","DOI":"10.1371\/journal.pone.0169400","article-title":"Prevalence of atrial fibrillation and antithrombotic therapy in hemodialysis patients: cross-sectional results of the Vienna InVestigation of AtriaL fibrillation and thromboembolism in patients on hemoDIalysis (VIVALDI)","volume":"12","author":"O K\u00f6nigsbr\u00fcgge","year":"2017","journal-title":"PLoS One"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"J Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"issue":"02","key":"ref13","first-page":"255","article-title":"Epidemiology of first and recurrent venous thromboembolism: a population-based cohort study in patients without active cancer","volume":"112","author":"C Martinez","year":"2014","journal-title":"Thromb Haemost"},{"issue":"24","key":"ref14","doi-asserted-by":"crossref","first-page":"5377","DOI":"10.1182\/blood-2010-02-270116","article-title":"Prediction of venous thromboembolism in cancer patients","volume":"116","author":"C Ay","year":"2010","journal-title":"Blood"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2007.02450.x","article-title":"Incidence and mortality of venous thrombosis: a population-based study","volume":"5","author":"I A Naess","year":"2007","journal-title":"J Thromb Haemost"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/j.avsg.2015.02.008","article-title":"Vascular access thrombosis in France: incidence and treatment patterns","volume":"29","author":"N Sadaghianloo","year":"2015","journal-title":"Ann Vasc Surg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1076029619888022","DOI":"10.1177\/1076029619888022","article-title":"Vena cava filters and in-hospital case fatality among patients with pulmonary embolism: results from a large population-based study","volume":"25","author":"F Pomero","year":"2019","journal-title":"Clin Appl Thromb Hemost"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1053\/j.ajkd.2021.12.017","article-title":"Association of frailty with thrombosis of hemodialysis vascular access: a prospective taiwanese cohort study","volume":"80","author":"C M Luo","year":"2022","journal-title":"Am J Kidney Dis"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/jth.12580","article-title":"The risk of venous thromboembolism in renal cell carcinoma patients with residual tumor thrombus","volume":"12","author":"R Ihaddadene","year":"2014","journal-title":"J Thromb Haemost"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1007\/s11239-015-1316-1","article-title":"Guidance for the evaluation and treatment of hereditary and acquired thrombophilia","volume":"41","author":"S M Stevens","year":"2016","journal-title":"J Thromb Thrombolysis"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1681\/ASN.2004110999","article-title":"Thrombophilia and the risk for hemodialysis vascular access thrombosis","volume":"16","author":"G A Knoll","year":"2005","journal-title":"J Am Soc Nephrol"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1093\/ndt\/11.4.668","article-title":"Resistance to activated protein C (APC): mutation at Arg506 of coagulation factor V and vascular access thrombosis in haemodialysis patients","volume":"11","author":"M F\u00f6dinger","year":"1996","journal-title":"Nephrol Dial Transplant"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"962","DOI":"10.2215\/CJN.03860412","article-title":"Thrombophilia and arteriovenous fistula survival in ESRD","volume":"8","author":"B Salmela","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"issue":"12","key":"ref24","doi-asserted-by":"crossref","first-page":"2984","DOI":"10.1111\/jth.15508","article-title":"Anticoagulation use and the risk of stroke and major bleeding in patients on hemodialysis: From the VIVALDI, a population-based prospective cohort study","volume":"19","author":"O K\u00f6nigsbr\u00fcgge","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"09","key":"ref25","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1097\/01.ASN.0000027356.16598.99","article-title":"Low-intensity warfarin is ineffective for the prevention of PTFE graft failure in patients on hemodialysis: a randomized controlled trial","volume":"13","author":"M A Crowther","year":"2002","journal-title":"J Am Soc Nephrol"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"693","DOI":"10.2215\/CJN.14021021","article-title":"Apixaban versus warfarin for treatment of venous thromboembolism in patients receiving long-term dialysis","volume":"17","author":"J B Wetmore","year":"2022","journal-title":"Clin J Am Soc Nephrol"},{"issue":"10","key":"ref27","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1002\/jhm.12926","article-title":"Safety and effectiveness of apixaban versus warfarin for acute venous thromboembolism in patients with end-stage kidney disease: a national cohort study","volume":"17","author":"M I Ellenbogen","year":"2022","journal-title":"J Hosp Med"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2700-6368.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:42:07Z","timestamp":1787870527000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2700-6368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":27,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2026,8,27]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2700-6368","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}