abspara0015">Prospective cohort study.
abspara0020">2,479 individuals (mean age, 65.1 ± 5.9 [SD] years; 43% men) from the population-based Rotterdam Study.
abspara0025">vWF, ADAMTS13, and vWF:ADAMTS13 ratio.
abspara0030">Annual decline in estimated glomerular filtration rate (eGFR), halving of eGFR, and new-onset eGFR < 60 mL/min/1.73 m2 were assessed.
abspara0035">During a median follow-up of 11 (range, 7.81-13.57) years, 500 cases of new-onset eGFR < 60 mL/min/1.73 m2 occurred. The population had a mean eGFR decline of 0.96 ± 0.92 mL/min/1.73 m2 per year. Higher vWF:ADAMTS13 ratio was associated with steeper annual decline in eGFR (difference, −0.06 [95% CI, −0.09 to −0.02] mL/min/1.73 m2 per year) and higher risk for new-onset eGFR < 60 mL/min/1.73 m2 (OR, 1.13; 95% CI, 1.01-1.27). Likewise, higher vWF:ADAMTS13 ratio was associated with higher risk for halving of eGFR (OR, 1.40; 95% CI, 1.02-1.93). After adjustment for cardiovascular risk factors and blood group, effect estimates remained the same.
abspara0040">No data available for albuminuria. Participants were classified based on a single measurement of vWF and ADAMTS13.
abspara0045">In this population-based study, we showed that higher vWF:ADAMTS13 ratio is associated with decline in kidney function, suggesting a role of elevated prothrombotic factors in the development and progression of kidney disease.