The risk of bleeding for antiplatelet agents in Haemodialysis patients: a Meta-analysis

BMC Nephrol. 2020 Mar 26;21(1):106. doi: 10.1186/s12882-020-01757-1.

Abstract

Background: The safety of antiplatelet therapy in haemodialysis (HD) patients remains controversial. we conducted the first meta-analysis to evaluate the bleeding risk with antiplatelet agents in these populations.

Methods: The relevant literature was searched using the following electronic databases without any language restrictions: the Cochrane Library, EMBASE, Global Health, MEDLINE, PubMed, and the Chinese Biomedical Database.

Results: Seven randomized controlled trials (RCTs) and 2 prospective cohort studies, consisting of 1131 patients, were identified for detailed evaluation. The meta-analysis suggested that the use of double antiplatelet agents increased the risk of bleeding in HD patients [odds ratio (OR) = 2.78; 95% confidence interval (CI) 1.63 to 4.76; I2 = 0], and antiplatelet agents increased the risk of bleeding in 7 RCTs [odds ratio (RR) = 1.40, 95% CI 1.08 to 1.79; I2 = 23%,]; however, the use of a single antiplatelet agent was not found to significantly increase the risk of bleeding (RR = 0.88; 95% CI 0.51 to 1.50; I2 = 0).

Conclusion: The results suggested that the use of double antiplatelet agents increased the risk of bleeding in HD patients.

Keywords: Anticoagulants; Aspirin; Bleeding; Clopidogrel; Haemodialysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases* / drug therapy
  • Cardiovascular Diseases* / epidemiology
  • Dual Anti-Platelet Therapy* / adverse effects
  • Dual Anti-Platelet Therapy* / methods
  • Hemorrhage / chemically induced*
  • Hemorrhage / prevention & control
  • Humans
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / therapy
  • Platelet Aggregation Inhibitors / pharmacology*
  • Renal Dialysis / methods*
  • Risk Assessment

Substances

  • Platelet Aggregation Inhibitors