Bleeding Risk in Hemodialysis Patients

van Eck van der Sluijs, Anita; Pai, Pearl; Zhu, Wenjuan; Ocak, Gurbey

doi:10.1016/j.semnephrol.2023.151478

Cited by 3 publications

(1 citation statement)

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“…Traditionally, atrial fibrillation is associated with a high thromboembolic risk, leading to the use of anticoagulants such as warfarin [3]. However, in patients undergoing HD, impaired platelet function and the use of medications such as heparin contribute to a heightened bleeding diathesis [4,5]. Anticoagulation in such patients may, paradoxically, result in increased complication rates or mortality [6].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of the Use of Warfarin in Patients with Atrial Fibrillation Undergoing Maintenance Hemodialysis

Kang,

Kim,

Kim

et al. 2024

JCM

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Background: We evaluated the impact of warfarin use on the clinical outcomes of patients with atrial fibrillation who were undergoing hemodialysis (HD). Methods: A retrospective analysis was conducted utilizing data from patients undergoing maintenance HD who participated in HD quality assessment programs. Patients who were assigned the diagnostic code for atrial fibrillation (n = 4829) were included and divided into two groups based on the use of warfarin: No group (no warfarin prescriptions (n = 4009)), and Warfarin group (warfarin prescriptions (n = 820)). Results: Cox regression analyses revealed that the hazard ratio for all-cause mortality in the Warfarin group was 1.15 (p = 0.005) in univariate analysis and 1.11 (p = 0.047) in multivariable analysis compared to that of the No group. Hemorrhagic stroke was significantly associated with warfarin use, but no significant association between the use of warfarin and ischemic stroke or cardiovascular events was observed. The subgroup results demonstrated similar trends. Conclusions: Warfarin use is associated with a higher risk of all-cause mortality and hemorrhagic stroke, and has a neutral effect on ischemic stroke and cardiovascular events in patients with atrial fibrillation who are undergoing HD, compared to those who are not using warfarin.

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