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Kidney Week

Abstract: FR-PO231

The Bleeding Risk of Adding Pentoxifylline to Aspirin in Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Wu, Chia-Chun, Chi Mei Medical Center, Tainan, Taiwan
  • Lu, Tzongshi, Brigham and Women's Hospital, Harvard Medical School, Natick, Massachusetts, United States
  • Chen, Jui-Yi, Chi Mei Medical Center, Tainan, Taiwan
Background

Pentoxifylline (PTX) is found renoprotective in chronic kidney disease (CKD) by the effects of antiinflammation, antifibrosis and improvement on hemorheology.
CKD is a risk factor of cardiovascular disease, therefore many patients with CKD are under antiplatelet treatment to prevent it . CKD is also known associated with a greater risk of bleeding. Herein, we want to know if adding on PTX in CKD patients who already under aspirin therapy will increase the risk of bleeding.

Methods

The National Health Insurance Research Database in Taiwan was used to identify patients who had diagnosis of CKD and under aspirin treatment longer than 3 months after CKD diagnosed. The exclusion criteria were having major bleeding events within one year prior the CKD diagnosed, liver cirrhosis, thrombocytopenia and history of hospitalization within three months before study index date.
Patients who received PTX after aspirin were selected as study group (PTX group), the remaining patients who without PTX treatment and matched on age, gender and years of CKD diagnosis were selected as control group.
The study outcome was any event of intracranial hemorrage (ICH) or gastrointestinal(GI) bleeding after using PTX.
A conditional logistic regression model was used to estimate the risk of bleeding in PTX treated patients.

Results

A total 607 patients in PTX group and 1214 in control group were analyzed. The mean age of both groups was 65.7+/-12.4 yeas old. PTX group had higher percentage of diabetes mellitus (DM)(44.48% vs 35.91%, p<0.001) and stroke history (18.29% vs 14.33%, p=0.029). The percentage of ICH and GI bleeding events was 1.48% and 14.83% in the PTX group; 1.89% and 11.86% in the control group, without significant difference. The risk of having a bleeding event was not significant different between PTX group and control group after adjusting the comorbidities of DM, hypertension, hyperlipidemia , stroke history and end stage renal disease. (Adjusted Odds Ratio(AOR) of ICH: 0.78, 95% Confidence Interval(CI): 0.38-1.62; AOR of GI bleeding: 1.4, 95%CI :0.98-1.72).

Conclusion

Add-on PTX in CKD patients who under aspirin treatment would not increase the risk of ICH and GI bleeding.