Background <p>Deep vein thrombosis (DVT) represents a significant and potentially lethal complication in bedridden elderly inpatients, leading to severe disability and mortality.</p> Purpose <p>This study aimed to identify determinants contributing to DVT incidence in elderly patients with concurrent hip fractures and chronic kidney disease (CKD).</p> Methods <p>We collected comprehensive data from elderly patients diagnosed with hip fractures and CKD at our hospital between November 2015 and January 2023. Patients were categorized into DVT and non-DVT groups. We conducted detailed demographic, comorbidity, and laboratory analyses using univariate and logistic regression methods. Receiver-operating characteristic (ROC) curves were utilized to establish critical thresholds for predictive variables.</p> Results <p>The study revealed a 34.4% DVT rate among 180 patients. Univariate analysis identified significant associations between DVT and older age (<i>p</i> = 0.031), elevated white blood cell (WBC) count (<i>p</i> = 0.005), prolonged thrombin time (TT) (<i>p</i> = 0.030), and increased D-dimer levels (<i>p</i> &lt; 0.001). Logistic regression showed that age (<i>p</i> = 0.009, odds ratio [OR] = 1.049), WBC count (<i>p</i> = 0.001, OR = 1.131), and D-dimer levels (<i>p</i> = 0.010, OR = 1.190) were independent predictors of DVT. ROC analysis established critical thresholds: age (73&#xa0;years), D-dimer (3.3&#xa0;ng/mL), and WBC count (9.5 × 10^9/μL).</p> Conclusions <p>Age, D-dimer, and WBC levels independently predict DVT in elderly patients with hip fractures and CKD. Precise thresholds facilitate personalized DVT risk assessment, enabling early and targeted interventions.</p>