TY - JOUR
T1 - Bleeding risk of haemodialysis and peritoneal dialysis patients
AU - van Eck van der Sluijs, Anita
AU - Abrahams, Alferso C
AU - Rookmaaker, Maarten B
AU - Verhaar, Marianne C
AU - Bos, Willem Jan W
AU - Blankestijn, Peter J
AU - Dekker, Friedo W
AU - van Diepen, Merel
AU - Ocak, Gurbey
N1 - Funding Information:
The Netherlands Cooperative Study on the Adequacy of Dialysis was funded by an unrestricted grant (E93.018) from the Dutch Kidney Foundation. The Dutch Kidney Foundation was not involved in the collection, interpretation and analysis of the data or in decisions on the writing and submission of this report for publication.
Publisher Copyright:
© The Author(s) 2020.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - BACKGROUND: Dialysis patients have an increased bleeding risk as compared with the general population. However, there is limited information whether bleeding risks are different for patients treated with haemodialysis (HD) or peritoneal dialysis (PD). From a clinical point of view, this information could influence therapy choice. Therefore the aim of this study was to investigate the association between dialysis modality and bleeding risk.METHODS: Incident dialysis patients from the Netherlands Cooperative Study on the Adequacy of Dialysis were prospectively followed for major bleeding events over 3 years. Hazard ratios with 95% confidence intervals (CIs) were calculated for HD compared with PD using a time-dependent Cox regression analysis, with updates on dialysis modality.RESULTS: In total, 1745 patients started dialysis, of whom 1211 (69.4%) received HD and 534 (30.6%) PD. The bleeding rate was 60.8/1000 person-years for HD patients and 34.6/1000 person-years for PD patients. The time-dependent Cox regression analysis showed that after adjustment for age, sex, primary kidney disease, prior bleeding, cardiovascular disease, antiplatelet drug use, vitamin K antagonist use, erythropoietin use, arterial hypertension, residual glomerular filtratin rate, haemoglobin and albumin levels, bleeding risk for HD patients compared with PD increased 1.5-fold (95% CI 1.0-2.2).CONCLUSIONS: In this large prospective cohort of incident dialysis patients, HD patients had an increased bleeding risk compared with PD patients. In particular, HD patients with a history of prior bleeding had an increased bleeding risk.
AB - BACKGROUND: Dialysis patients have an increased bleeding risk as compared with the general population. However, there is limited information whether bleeding risks are different for patients treated with haemodialysis (HD) or peritoneal dialysis (PD). From a clinical point of view, this information could influence therapy choice. Therefore the aim of this study was to investigate the association between dialysis modality and bleeding risk.METHODS: Incident dialysis patients from the Netherlands Cooperative Study on the Adequacy of Dialysis were prospectively followed for major bleeding events over 3 years. Hazard ratios with 95% confidence intervals (CIs) were calculated for HD compared with PD using a time-dependent Cox regression analysis, with updates on dialysis modality.RESULTS: In total, 1745 patients started dialysis, of whom 1211 (69.4%) received HD and 534 (30.6%) PD. The bleeding rate was 60.8/1000 person-years for HD patients and 34.6/1000 person-years for PD patients. The time-dependent Cox regression analysis showed that after adjustment for age, sex, primary kidney disease, prior bleeding, cardiovascular disease, antiplatelet drug use, vitamin K antagonist use, erythropoietin use, arterial hypertension, residual glomerular filtratin rate, haemoglobin and albumin levels, bleeding risk for HD patients compared with PD increased 1.5-fold (95% CI 1.0-2.2).CONCLUSIONS: In this large prospective cohort of incident dialysis patients, HD patients had an increased bleeding risk compared with PD patients. In particular, HD patients with a history of prior bleeding had an increased bleeding risk.
KW - Bleeding
KW - End-stage kidney disease
KW - Haemodialysis
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=85099172095&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfaa216
DO - 10.1093/ndt/gfaa216
M3 - Article
C2 - 33130878
SN - 0931-0509
VL - 36
SP - 170
EP - 175
JO - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
IS - 1
ER -