Association between anticoagulation strategy and quality of life in chronic hemodialysis patients

Area of Science:

• Nephrology
• Hematology
• Clinical Research

Background:

• Clotting prevention in hemodialysis (HD) is essential but monitoring anticoagulation and bleeding is limited.
• Data on bleeding complications and their impact on Quality of Life (QoL) in HD patients are scarce.

Purpose of the Study:

• To assess bleeding tendency and its correlation with anticoagulation strategies and QoL in maintenance HD patients.
• To investigate the relationship between anticoagulation dose, bleeding events, and patient-reported QoL outcomes.

Main Methods:

• Prospective longitudinal observational study involving 70 HD patients.
• Utilized ISTH-BAT and HAS-BLED scores to assess bleeding tendency at baseline and follow-up.
• Assessed QoL using EQ5D-3L and Visual Analogue Scale (VAS) questionnaires; quantified hemodialyzer fiber patency via micro-CT scanning.

Main Results:

• Bleeding scores indicated a notable tendency for bleeding, with observed bruises/hematomas.
• Higher anticoagulation doses correlated with worse VAS scores (po < 0.027).
• Patients identified with bleeding tendency by ISTH also reported worse VAS scores (po < 0.010).

Conclusions:

• Current anticoagulation regimens in maintenance HD may be excessive, leading to increased minor bleeding.
• Excessive anticoagulation potentially negatively impacts the health-related quality of life in HD patients.
• Further research is warranted to optimize anticoagulation strategies and improve patient QoL in hemodialysis.