Kidney Function Affects Bleeding Risk in Antithrombotic Therapy

Reduced kidney function caused by antithrombotic medications can significantly influence bleeding events, according to a study published in BMC Medicine. Patients with heart arrhythmia (atrial fibrillation) have a high risk for thrombotic events in blood vessels that could lead to permanent organ damage such as cerebral infarction and are prescribed antithrombotic therapy to lower their risk of developing blood clots.

However, the risk of bleeding events simultaneously increases due to the nature of these medications. The severity of these bleeding events is highly variable, ranging from epistaxis (nosebleeds) to fatal brain hemorrhage.

Researchers at Kumamoto, Miyazaki, and Tohoku Universities in Japan conducted a study to determine the impact of kidney function on the risk of recurrent bleeding events during antithrombotic therapy.

Their analysis revealed that the effect of kidney function on recurrent bleeding risk events was quite large for patients undergoing this treatment.

The decision to use such a therapy should be balanced between the expected antithrombotic effects and bleeding risks.

In most cases, it is considered better to continue antithrombotic therapies even after bleeding events as long as the event was not severe. However, it is not surprising that both patients and physicians hesitate to continue the therapy after any bleeding event.

To assess for drug safety and efficacy, these drugs are usually measured by the numbers of bleeding and thrombotic events. Unfortunately, in the assessment of antithrombotic therapy, most studies only consider the first event in their analyses even though patients could experience multiple events throughout their lifetime.

Furthermore, patients with healthy kidney function appear to have a decreased risk of experiencing a bleeding event over time, but the risk for patients with reduced kidney function remains high as time continues.



Source-Medindia