Evidence map›Paper›PMID 34080321›Full record

ArticleClinical and translational science2021

Consequences of oral antithrombotic use in patients with chronic kidney disease.

Solène M Laville, Oriane Lambert, Aghiles Hamroun, Marie Metzger, Christian Jacquelinet, Maurice Laville, Luc Frimat, Denis Fouque, Christian Combe, Carole Ayav and 5 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Clinical and translational science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03381950 (Chronic Kidney Disease - Renal Epidemiology and Information Network), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03381950 completednot on this map

Chronic Kidney Disease - Renal Epidemiology and Information Network: The CKD-REIN Cohort

TypeobservationalSponsorInstitut National de la Santé Et de la Recherche Médicale, FranceRan2013 to 2020Enrolled3,033ConditionsRenal Insufficiency, Chronic
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 2 countries.

Solène M LavilleCentre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France.ORCID 0000-0002-0214-5567
Oriane LambertCentre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France.
Aghiles HamrounCentre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France.
Marie MetzgerCentre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France.
Christian JacquelinetBiomedecine Agency, Saint Denis La Plaine, France.
Maurice LavilleCarMeN INSERM 1060, et AURAL, Université de Lyon, Lyon, France.
Luc FrimatNephrology Department, CHRU de Nancy, Vandoeuvre-lès-Nancy, France.
Denis FouqueNephrology Department, Centre Hospitalier Lyon Sud, Université de Lyon, Carmen, Pierre-Bénite, France.
Christian CombeService de Néphrologie Transplantation Dialyse Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Carole AyavAPEMAC, Lorraine University, Vandoeuvre-lès-Nancy, France.
Roberto Pecoits-FilhoArbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
Bénédicte StengelCentre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France.
Ziad A MassyCentre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France.
Sophie LiabeufDepartment of Clinical Pharmacology, Amiens University Hospital, Amiens, France.ORCID 0000-0001-5384-9006
CKD-REIN Study Collaborators
Inserm · FRUniversité Claude Bernard Lyon 1 · FRAgence de la Biomédecine · FRArbor Research Collaborative for Health · USAssociated Press · USCentre Hospitalier Régional et Universitaire de Nancy · FRCentre Hospitalier Universitaire Amiens-Picardie · FRInterdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est · FRUniversité de Bordeaux · FR

Funding

AmgenAstraZenecaBaxterFresenius Medical CareLillyMerck Sharp & Dohme-ChibretSanofi-GenzymeVifor Fresenius
6 · The paper itself

Abstract

We assessed the risks of bleeding, acute kidney injury (AKI), and kidney failure associated with the prescription of antithrombotic agents (oral anticoagulants and/or antiplatelet agents) in patients with moderate-to-advanced chronic kidney disease (CKD). CKD-REIN is a prospective cohort of 3022 nephrology outpatients with CKD stages 2-5 at baseline. We used cause-specific Cox proportional hazard models to estimate hazard ratios (HRs) for bleeding (identified through hospitalizations), AKI, and kidney failure. Prescriptions of oral antithrombotics were treated as time-dependent variables. At baseline, 339 (11%) patients (65% men; 69 [60-76] years) were prescribed oral anticoagulants only, 1095 (36%) antiplatelets only, and 101 (3%) both type of oral antithrombotics. Over a median (interquartile range [IQR]) follow-up period of 3.0 (IQR, 2.8-3.1) years, 152 patients experienced a bleeding event, 414 patients experienced an episode of AKI, and 270 experienced kidney failure. The adjusted HRs (95% confidence interval [95% CI]) for bleeding associated with prescriptions of antiplatelets only, oral anticoagulants only, and antiplatelet + oral anticoagulant were, respectively, 0.74 (95% CI, 0.46-1.19), 2.38 (95% CI, 1.45-3.89), and 3.96 (95% CI, 2.20-7.12). An increased risk of AKI risk was associated with the prescription of oral anticoagulants (adjusted HR, 1.90, 95% CI, 1.47-2.45) but not the prescription of antiplatelets (HR, 1.24, 95% CI, 0.98-1.56). Kidney failure was not associated with the prescription of oral antithrombotics of any type. This study confirms the high risk of AKI associated with oral anticoagulants prescription in patients with CKD and also highlights the potential aggravating effect of combining vitamin K antagonist (VKA) and antiplatelets on the risk of bleeding.

Indexed as

Renal Insufficiency, ChronicAcute Kidney InjuryAdministration, OralAgedAnticoagulantsAtrial FibrillationDisease ProgressionFemaleHumansMaleMiddle AgedPlatelet Aggregation InhibitorsProspective StudiesAnticoagulantsPlatelet Aggregation Inhibitors

Identifiers

PMID34080321
PMCPMC8604253
OpenAlexW3164034149

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.