在血液透析和腹腔透析患者中使用抗血栓治疗的跨国现实世界实践模式

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Murilo Guedes¹, Calvin Andrews², Junhui Zhao²

¹Department of Medicine, Stanford University, Stanford, CA.

Kidney medicine

|February 12, 2026

概括

抗血栓药物使用率较低,在透析患者中经常停止使用,他们经历高出血率. 需要新的策略来平衡这些药物的风险和益处在功能衰竭患者.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
心脏病学心脏病学
药理学药理学是指药理学的学科.

背景情况:

维持透析的患者患有高心血管事件的风险,需要抗血栓治疗,如口服抗凝剂 (OAC) 或抗血小板治疗 (APT).
慢性抗血栓治疗增加了透析患者的出血风险,但现实世界的药物使用模式和出血事件风险尚不清楚.

研究的目的:

调查口服抗凝剂 (OAC) 和抗血小板治疗 (APT) 使用的模式.
评估在接受血液透析 (HD) 或腹腔透析 (PD) 的患者中与抗血栓治疗相关的出血事件的风险.

主要方法:

来自国际透析结果和实践模式研究 (DOPPS) 和腹膜 DOPPS (PDOPPS) 队列的数据的回顾性分析.
包括27,612名HD患者和5,289名PD患者,分析了人口统计数据,并发病情况,OAC和APT使用.
用描述性分析和卡普兰-梅尔方法来评估药物使用,停药和出血的复合结果.

主要成果:

基线OAC和APT使用率较低:HD患者的9%和10%,PD患者的4%和7%.
抗血栓使用者年龄较大,有更多的心血管疾病史.
36个月后,OAC和APT的持续率分别为57%和53%. 每100个患者年复合出血率为OAC的8.6,HD患者的APT为5.6,PD患者的OAC为12.0和APT为6.1.

结论:

在接受HD或PD的患者中,抗血栓药物很少被处方,并且经常被中止.
在透析患者中,抗血栓使用者的重大出血事件率很高.
需要新的策略来优化在透析中功能衰竭的患者中抗血栓剂的风险益处概况.

关键词:

透析是通过透析进行的.抗凝固剂是一种抗凝固剂.这是一种抗血小板药物,抗血小板药物.流血出血流血出血

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