A RECENT study analysing data from the US Renal Data System (USRDS) has revealed a significant risk of pulmonary embolism (PE) in patients with end-stage kidney disease (ESKD) starting dialysis. The research, which tracked 288,073 patients from 2011 to 2019, found a 1-year PE incidence of 0.84%, with rates increasing over the study period. Patients on peritoneal dialysis (PD) had a lower incidence of PE compared to those on haemodialysis (HD).
The study also highlighted challenges in managing PE in ESKD patients, especially regarding anticoagulation (AC) therapy. Only 41% of patients prescribed AC filled their prescriptions, and no significant benefit was found in preventing PE recurrence between those who took AC and those who didn’t. Mortality rates were high—13.7% in-hospital and 13.1% at 30 days post-discharge—indicating the severity of PE in this high-risk group.
This research highlights the complexities of managing PE in ESKD patients, stressing the need for further investigation into optimal treatment strategies and the underlying causes of increased thrombotic risk to improve outcomes in this population.
Helena Bradbury, EMJ
Reference
Patel KN et al. Pulmonary embolism in patients with end-stage kidney disease starting dialysis. JAMA Netw Open. 2025;8(3):e250848.
