Abstract: FR-PO1173
Association of Kidney Damage Markers with Bleeding Risk in CKD and Atrial Fibrillation During Rivaroxaban Treatment
Session Information
- CKD: Screening, Diagnosis, Serum and Urine Biomarkers, and Scoring Indices
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Igamberdieva, Ranokhon, Tashkent Pediatric Medical Institute, Tashkent, Tashkent Province, Uzbekistan
- Abdullaev, Sherzod, Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation, Tashkent, Tashkent Province, Uzbekistan
Background
In patients with chronic kidney disease (CKD), the presence of concomitant atrial fibrillation (AF) causes an increase in thromboembolic complications and bleeding, against the background of antithrombotic drugs, especially in elderly and senile individuals. The aim of this study was to evaluate the possible relationship between the presence of bleeding in patients with CKD stages C3–4 and AF receiving rivaroxaban and the level of renal damage markers in urine.
Methods
The study included 266 patients aged 65-97 years: 140 patients with AF and CKD C3a and 126 patients with AF and CKD C3b and C4. Patients received rivaroxaban therapy. All patients underwent a retrospective assessment of the presence of bleeding according to the HAS-BLED scale, analysis of the excretion of markers of renal injury (albumin; nephrin; neutrophil gelatinase-associated lipocalin (NGAL); kidney injury molecule-1 (KIM-1)) with urine. Additionally, an analysis of the level of markers of renal damage in the urine of 90 healthy volunteers was performed.
Results
According to the risk of bleeding, patients were divided into 2 groups: Group 1 included patients with ≥1 point (92 patients), average age 80.7 years). Group 2 included patients with 0 points: 174 patients, average age 78.2 years. Of the bleeding, bruises were common in 19%, nosebleeds were found in 8.3%, bleeding from minor wounds was noted in 4.3%, muscle hematomas were found in 2.2%, bleeding from the oral cavity was found in 2.2%, and hemorrhoidal bleeding was diagnosed in 0.75%. The levels of NGAL and KIM-1 in urine in patients with AF and CKD in group 1 (5.6 ng/ml and 0.69 ng/ml, respectively) were statistically significantly higher compared to patients in group 2 (4.2 ng/ml (ρ=0.039) and 0.39 ng/ml (ρ=0.019, Table 1).
Conclusion
Our study results indicate the presence of a statistically significant association between the presence of bleeding in patients with AF and CKD stages 3–4 receiving rivaroxaban with the level of tubular damage markers KIM-1 and NGAL in urine.
Table 1. Urinary excretion level of kidney damage markers in relation to bleeding risk.
| Parameters (ng/ml) | Control group (n =90) | 1-group (n =92) | 2-group (n =174) | ρ1-2 | ρ1-3 | ρ2-3 |
| Nephrin | 0,25 (0,23-0,3) | 0,87 (0,33-1,34) | 0,63 (0,31-1,02) | <0,001 | <0,001 | 0,16 |
| NGAL | 2,7 (2,0-4,4) | 5,6 (3,82-23,84) | 4,2 (2,23-15,54) | <0,001 | 0,006 | 0,039 |
| KIM-1 | 0,22 (0,11-0,7) | 0,69 (0,28-1,11) | 0,39 (0,14-0,67) | 0,003 | 0,17 | 0,019 |