Impact of the Number of Anti-Thrombosis Agents in Hemodialysis Patients: BOREAS-HD2 Study

• Main Authors: Marenao Tanaka (Author), Norihito Moniwa (Author), Hirofumi Ohnishi (Author), Tomohisa Yamashita (Author), Masayuki Koyama (Author), Yufu Gocho (Author), Keitaro Nishizawa (Author), Yukishige Kimura (Author), Hirohito Sugawara (Author), Sayaka Murakami (Author), Yusuke Okazaki (Author), Masato Furuhashi (Author), Hideaki Yoshida (Author), Tetsuji Miura (Author)
• Format: Book
• Published: Karger Publishers, 2017-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background/Aims: Relationships between the number of anti-thrombosis agents, clinical benefits and adverse events in hemodialysis (HD) patients are unclear. Methods: All patients on HD in 22 institutes (n = 1,071) were enrolled and followed up for 3 years. After exclusion of patients with missing data, kidney transplantation or retraction of consent during the follow-up period (n = 204), mortality rate and ischemic and hemorrhagic events were compared between different regimens of anti-thrombosis agents. Results: The use of dual or triple antiplatelet (AP) agents (HR:2.03, 95% CI:1.01-4.13, p = 0.04) and the combination of an AP agent and warfarin (WF) (HR:4.84, 95%CI 1.96-11.96, p < 0.001) were associated with an increase in hemorrhagic events compared with no use of anti-thrombosis agents. No anti-thrombosis regimen was associated with a significant change in risk of ischemic stroke. The use of dual or triple AP agents, but not WF, was associated with an increase in cardiovascular mortality (HR:2.48, 95% CI:1.24-4.76, p = 0.01). Conclusion: A significant increase in hemorrhagic events by the use of dual or more AP agents and by co-administration of an AP agent and WF in patients on HD should be considered in planning their anti-thrombosis regimen.

Item Description

1420-4096
1423-0143
10.1159/000480487