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C -W Huang, M -J Lee, C -Y Hsu, K -J Chou, H -C Fang, L -J Wang, C -L Chen, C -K Huang, H -Y Chen, P -T Lee, Clinical outcomes associated with anti-coagulant therapy in patients with renal infarction, QJM: An International Journal of Medicine, Volume 111, Issue 12, December 2018, Pages 867–873, https://doi.org/10.1093/qjmed/hcy205
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Abstract
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.
To assess the impact of anti-coagulant therapy on outcomes in patients with renal infarction.
A retrospective cohort study of 101 renal infarction patients was conducted.
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.
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.
Anti-coagulant therapy in patients with renal infarction was associated with better survival and reduced thromboembolic complications.
