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- Title
Clinical outcomes associated with anti-coagulant therapy in patients with renal infarction.
- Authors
Huang, C -W; Lee, M -J; Hsu, C -Y; Chou, K -J; Fang, H -C; Wang, L -J; Chen, C -L; Huang, C -K; Chen, H -Y; Lee, P -T
- Abstract
Background Patients with renal infarction are vulnerable to thromboembolic complications with poor outcomes. There is limited report concerning the effect of anti-coagulant therapy in this population. Aim To assess the impact of anti-coagulant therapy on outcomes in patients with renal infarction. Design A retrospective cohort study of 101 renal infarction patients was conducted. Methods The association between anti-coagulant therapy, all-cause mortality, thromboembolic complications and renal outcome was evaluated. Demographic data and comorbidities were collected for analysis. Anti-coagulant therapy was treated as a time-dependent variable. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multi-variate Cox proportional hazards models. Results Fifty-seven (56.4%) patients with renal infarction received anti-coagulant therapy during the study period. The all-cause mortality rate was 7.56 per 100 patient-years. Age (HR 1.05, 95% CI 1.02–1.08) was a risk factor for all-cause mortality and anti-coagulant therapy was associated with a 92% improved survival (HR 0.08, 95% CI 0.02–0.34). Twelve (11.9%) thromboembolic events occurred following renal infarction. Current smoking (HR 10.37, 95% CI 1.60–67.43) had an adverse effect and anti-coagulant therapy (HR 0.14, 95% CI 0.03–0.73) had a significant protective impact on thromboembolic complications. There was no significant association between anti-coagulant therapy and long-term renal outcome in renal infarction patients including the monthly change in the estimated glomerular filtration rate (eGFR), the incidence of eGFR reduction of more than 50% and end-stage renal disease. Conclusion Anti-coagulant therapy in patients with renal infarction was associated with better survival and reduced thromboembolic complications.
- Subjects
CHRONIC kidney failure; PROPORTIONAL hazards models; INFARCTION; GLOMERULAR filtration rate
- Publication
QJM: An International Journal of Medicine, 2018, Vol 111, Issue 12, p867
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcy205