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

Matsuhiko Hayashi, Takayuki Abe, Mieko Iwai, Ayumi Matsui, Tadashi Yoshida, Yuji Sato, Yoshihiko Kanno, Warfarin Study Group The Warfarin Study Group

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: We conducted a multicenter prospective cohort study to assess the safety of warfarin therapy in Japanese hemodialysis (HD) patients. Methods: Chronic HD patients on warfarin therapy (warfarin users) were recruited from 111 HD centers in Japan. Two dialysis-vintage-matched warfarin non-users (non-users) were selected from the same HD center as each warfarin user. Clinical data were collected upon registration and every 12 months thereafter for up to 36 months. Results: The final cohort consisted of 365 warfarin users and 692 non-users and was followed for an average of 27.7 months. The mean age of warfarin users (68.8 ± 10.6 years) was significantly higher than that of non-users (66.9 ± 11.0 years, p <0.001). The analyses by multivariate Cox proportional-hazard models showed that the age [hazard ratio (HR) = 1.07 for each 1-year increase, 95 % confidence interval (CI) 1.05–1.08, p <0.001] was significantly associated with the death from any cause, but warfarin use (1.08, CI 0.75–1.57, p = 0.68) was not when being adjusted for sex, diabetes mellitus, antiplatelet use, and atrial fibrillation. The risk of composite events, which included death from any cause, stroke, cardiovascular disease, and peripheral arterial disease, was also associated with age but was not associated with warfarin use. Conclusion: The results of this study suggested that warfarin use by HD patients might not be harmful in chronic state, while the safety for the initiation of warfarin therapy in HD patients remained to be determined.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalClinical and Experimental Nephrology
DOIs
Publication statusAccepted/In press - 2015 Dec 1

Fingerprint

Warfarin
Renal Dialysis
Cohort Studies
Prospective Studies
Safety
Therapeutics
Cause of Death
Confidence Intervals
Peripheral Arterial Disease
Proportional Hazards Models
Atrial Fibrillation
Dialysis
Diabetes Mellitus
Japan
Cardiovascular Diseases
Multivariate Analysis
Stroke

Keywords

  • Anticoagulation
  • Atrial fibrillation
  • Calciphylaxis
  • Cardiovascular disease
  • Hemodialysis

ASJC Scopus subject areas

  • Nephrology
  • Physiology
  • Physiology (medical)

Cite this

Hayashi, M., Abe, T., Iwai, M., Matsui, A., Yoshida, T., Sato, Y., ... The Warfarin Study Group, W. S. G. (Accepted/In press). Safety of warfarin therapy in chronic hemodialysis patients: a prospective cohort study. Clinical and Experimental Nephrology, 1-8. https://doi.org/10.1007/s10157-015-1205-0

Safety of warfarin therapy in chronic hemodialysis patients : a prospective cohort study. / Hayashi, Matsuhiko; Abe, Takayuki; Iwai, Mieko; Matsui, Ayumi; Yoshida, Tadashi; Sato, Yuji; Kanno, Yoshihiko; The Warfarin Study Group, Warfarin Study Group.

In: Clinical and Experimental Nephrology, 01.12.2015, p. 1-8.

Research output: Contribution to journalArticle

Hayashi, Matsuhiko ; Abe, Takayuki ; Iwai, Mieko ; Matsui, Ayumi ; Yoshida, Tadashi ; Sato, Yuji ; Kanno, Yoshihiko ; The Warfarin Study Group, Warfarin Study Group. / Safety of warfarin therapy in chronic hemodialysis patients : a prospective cohort study. In: Clinical and Experimental Nephrology. 2015 ; pp. 1-8.
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AB - Background: We conducted a multicenter prospective cohort study to assess the safety of warfarin therapy in Japanese hemodialysis (HD) patients. Methods: Chronic HD patients on warfarin therapy (warfarin users) were recruited from 111 HD centers in Japan. Two dialysis-vintage-matched warfarin non-users (non-users) were selected from the same HD center as each warfarin user. Clinical data were collected upon registration and every 12 months thereafter for up to 36 months. Results: The final cohort consisted of 365 warfarin users and 692 non-users and was followed for an average of 27.7 months. The mean age of warfarin users (68.8 ± 10.6 years) was significantly higher than that of non-users (66.9 ± 11.0 years, p <0.001). The analyses by multivariate Cox proportional-hazard models showed that the age [hazard ratio (HR) = 1.07 for each 1-year increase, 95 % confidence interval (CI) 1.05–1.08, p <0.001] was significantly associated with the death from any cause, but warfarin use (1.08, CI 0.75–1.57, p = 0.68) was not when being adjusted for sex, diabetes mellitus, antiplatelet use, and atrial fibrillation. The risk of composite events, which included death from any cause, stroke, cardiovascular disease, and peripheral arterial disease, was also associated with age but was not associated with warfarin use. Conclusion: The results of this study suggested that warfarin use by HD patients might not be harmful in chronic state, while the safety for the initiation of warfarin therapy in HD patients remained to be determined.

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KW - Cardiovascular disease

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