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Safety of warfarin therapy in chronic hemodialysis patients: a prospective cohort study

Matsuhiko Hayashi1, Takayuki Abe2,3, Mieko Iwai4

  • 1Apheresis and Dialysis Center, Keio University School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160-8582, Tokyo, Japan. matuhiko@keio.jp.

Clinical and Experimental Nephrology
|December 3, 2015
PubMed

Insights

Warfarin therapy in Japanese hemodialysis patients appears safe for chronic use, with no increased risk of death or composite events. However, safety during therapy initiation requires further investigation.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Assessing the safety of warfarin therapy in Japanese hemodialysis (HD) patients.
  • Warfarin is a common anticoagulant, but its use in HD patients requires careful consideration due to potential bleeding risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of warfarin in Japanese patients undergoing chronic hemodialysis.
  • To determine if warfarin use is associated with increased mortality or adverse cardiovascular events in this population.

Main Methods:

  • A multicenter prospective cohort study involving 365 warfarin users and 692 non-users from 111 HD centers in Japan.
  • Patients were followed for up to 36 months, with clinical data collected at baseline and annually.
  • Multivariate Cox proportional-hazard models were used to analyze the association between warfarin use, age, and clinical outcomes.

Main Results:

  • Warfarin use was not significantly associated with an increased risk of death from any cause (HR 1.08, p=0.68) after adjusting for covariates.
  • Age was a significant predictor of mortality (HR 1.07 per year increase, p<0.001).
  • The risk of composite events (death, stroke, cardiovascular disease, peripheral arterial disease) was also not associated with warfarin use.

Conclusions:

  • Warfarin therapy may be safe for Japanese hemodialysis patients in the chronic state.
  • Further research is needed to determine the safety of initiating warfarin therapy in this patient group.
Abstract

Keywords:
AnticoagulationAtrial fibrillationCalciphylaxisCardiovascular diseaseHemodialysis

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