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Abstract: TH-PO552

Association Between Ongoing Antithrombotic Agents and Renal Biopsy Bleeding Complication

Session Information

  • Pathology and Lab Medicine
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

  • 1700 Pathology and Lab Medicine

Authors

  • Miyashita, Ryumon, Ashikaga Sekijuji Byoin, Ashikaga, Tochigi, Japan
  • Hirano, Keita, Ashikaga Sekijuji Byoin, Ashikaga, Tochigi, Japan
  • Ohkido, Ichiro, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan
  • Tsuboi, Nobuo, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan
  • Yokoo, Takashi, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan
Background

Numbers of kidney disease patients with prescribed antithrombotics have been growing because of their increased cardiovascular risk. Stopping them prior to renal biopsy can lead to delays in diagnosis and treatment, and increase the likelihood of ischemic events. Since there have been few studies examining bleeding complications due to continued antithrombotics up to the time of renal biopsy, we aimed to retrospectively examine this risk of bleeding in our historical cohort of renal biopsy.

Methods

Patients undergoing ultrasound-guided renal biopsy at our hospital between 2013 and 2021 were enrolled. Observation period was one week before and after renal biopsy. Exposure was any antithrombotics continued during the observation period. Control was no antithrombotics during this period. Primary outcome was change in hemoglobin levels from the day of biopsy to one day after. Secondary outcome was any macroscopic hematuria within 7 days after biopsy. Matching with 1:1 ratio on the basis of derived propensity scores for the treatment with antithrombotic agents was used to balance baseline characteristics between exposure and control.

Results

Among enrolled 1392 patients, 156 patients in antithrombotic group (antiplatelet 117 [75.0%], anticoagulant 33 [21.2%], both of them 6 [3.8%]) were matched. The top two most commonly prescribed antiplatelet and anticoagulant agents were Acetylsalicylic acid and Clopidogrel, and Warfarin and Apixaban, respectively. Difference in change of hemoglobin levels between antithrombotic and control groups was not significant (mean -0.14 g/dl, standard error 0.12, 95% confidence interval [CI] -0.37 to 0.10, P=0.243). The risk of macroscopic hematuria after renal biopsy in antithrombotic group was not significant compared to control (odds ratio 0.85, 95% CI 0.45 to 1.62, P=0.623).

Conclusion

Our retrospective single center study has demonstrated that continuing antithrombotic agents at the time of renal biopsy was not significantly associated with increased risk of bleeding.