Coagulative Complication Patterns in Patients on
Chronic Hemodialysis: A Longitudinal, Multicenter,
Observational Study in Thailand
Kriengsak Vareesangthip MD, PhD*, for the THEORY investigators
Affiliation :
* Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To characterize in real-life the clinical patterns in terms of coagulative complications in end-stage renal disease
(ESRD) patients undergoing hemodialysis in Thailand.
Material and Method: The study was multicenter, observational in design, comprising 9-month prospective cohort, and
3-month retrospective data collection at baseline. Data related to patient profiles, hemodialysis managements, and coagulative
complications were collected. Analyzes were done by means of descriptive statistics.
Results : Five hundred ninety eight patients [male 55.7%, mean age 55.4 (SD 14.7) years] with chronic hemodialysis were
enrolled. Mean hemodialysis life-time was 7.1 (SD 4.3) years. Two most common ESRD etiologies were diabetes (26.6%)
and hypertension (23.5%). The majority of patients (68.4%) had hemodialysis twice-a-week, rather than three times per
week. Fifty-seven coagulative complications were reported over one year, of which 24 (4.0%, 95% confidence interval (CI)
0 to 8.95) were bleeding, 24 (4.0%, 95% CI 0 to 8.95) were thrombosis, seven (1.2%) were thrombocytopenia, and one
(0.1%) was coagulopathy. Twelve events were considered serious (eight bleedings, two of which were fatal cerebrovascular
accidents, two thrombocytopenia, and two thrombosis events).
Conclusion : Patient and treatment profiles, including complications, among ESRD patients undergoing chronic hemodialysis
in real life were characterized in current study. The incidence profiles of coagulative complications reported in the present
study would add a clearer image of safety on anticoagulative agent usage in this group of Thai patients.
Keywords : Hemodialysis, Management, Complication, Anticoagulant, Observation study
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