Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251405422. doi: 10.1177/10760296251405422. Epub 2025 Dec 5.
ABSTRACT
ObjectiveTo analyze 180-day survival and associated factors in patients with chronic kidney disease (CKD) who initiated anticoagulation therapy during hospitalization.MethodsA survival analysis study was conducted using Kaplan-Meier curves on a retrospective cohort of CKD patients on anticoagulation. Cox regression identified factors associated with survival differences.ResultsThe study included 224 patients (50.90% male, 71.80% > 65 years, 30.80% with atrial fibrillation (AF), and 50% with venous thromboembolism (VTE)). Mortality was 40.63%, with higher survival in the AF group versus VTE (p = 0.0107), CKD stage 3a versus stage 4 (p = 0.0009), and stage 5 versus stage 4 (p = 0.0277). Mortality risk was higher in patients with subsidized healthcare (HR 1.47; 95% CI 1.17-3.12; p = 0.010), cancer (HR 1.77; 95% CI 1.15-2.71; p = 0.008), and VTE (HR 1.87; 95% CI 1.22-2.86; p = 0.004), Arterial hypertension (HR 0.44; 95% CI 0.29-0.68; p = 0.001), coronary artery disease (HR 0.42; 95% CI 0.20-0.48; p = 0.022), and antiplatelet monotherapy (HR 0.56; 95% CI 0.32-0.96; p = 0.037) did not influence survival.ConclusionsCKD patients on anticoagulation therapy have high early mortality. Cancer, subsidized healthcare affiliation, and venous thromboembolism were independent risk factors associated with mortality, whereas hypertension and single antiplatelet therapy were not. This suggests that intensified follow-up and individualized management strategies may be particularly beneficial in these high-risk groups. Larger, prospective studies are needed to optimize anticoagulation management in this high-risk population.
PMID:41348535 | DOI:10.1177/10760296251405422