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Kidney Week

Abstract: PO0034

Risk of Incident Bleeding After AKI: A Retrospective Cohort Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Zarka, Farah, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Tayler-Gomez, Alexandre, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Ducruet, Thierry, CHU Ste-Justine, Montreal, Quebec, Canada
  • Duca, Anatolie, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Albert, Martin, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Bernier-Jean, Amelie, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Bouchard, Josee, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
Background

End-stage kidney disease (ESKD) causes bleeding diathesis; however, whether these findings are extrapolable to acute kidney injury (AKI) remains uncertain. We assessed whether AKI is associated with an increased risk of de novo bleeding.

Methods

We conducted a one-year single-center retrospective cohort study, excluding readmissions, admissions less than 24 hours, ESKD or kidney transplant patients. The primary outcome was the development of incident bleeding analyzed by multivariate time-dependent Cox models and independently adjudicated by two investigators.

Results

In 1,001 patients, bleeding occurred in 48% of AKI and 57% of non-AKI patients (p=0.007). To identify predictors of incident bleeding, we excluded patients who bled before ICU (n=488). In bleeding-free patients (n=513), we observed a trend toward higher risks of bleeding in AKI (22% vs. 16%,p=0.06), and a higher risk of bleeding in AKI-requiring dialysis (38% vs. 17%, p=0.01). Cirrhosis, AKI-requiring dialysis, anticoagulation, and coronary artery disease were associated with bleeding (HR 3.67, 95%CI:1.33-10.25; HR 2.82, 95%CI:1.26–6.32; HR 2.34, 95%CI:1.45–3.80; and HR 1.84, 95%CI:1.06–3.20, respectively), while SOFA score and sepsis had a protective association (HR 0.92 95%CI:0.84-0.99 and HR 0.55, 95%CI:0.34–0.91, respectively). Incident bleeding was not associated with mortality.

Conclusion

AKI-requiring dialysis was associated with incident bleeding, independent of anticoagulant administration. Studies are needed to better understand how AKI affects coagulation and clinical outcomes.

Funding

  • Government Support - Non-U.S.