Abstract Number: PB0438
Meeting: ISTH 2021 Congress
Background: Chronic kidney disease (CKD) patients undergoing haemodialysis (HD) and peritoneal dialysis (PD) have increased bleeding risk based on the previous limited studies. The HD patients tend to have higher bleeding risk compared with PD patients, although the results were still inconclusive. Almost CKD patients receive antiplatelet therapy that affect the bleeding risk, yet the result is inconsistent.
Aims: This study aims to measure the incidence comparison and the platelet effect on bleeding risk between HD and PD patients.
Methods: We did both hand-searching and comprehensive literature searching in online databases of Pubmed, ScienceDirect, and The Cochrane Library, to include all relevant studies from 2000 until 2021. This study follows the PRISMA guideline. We included all cohort studies that compare and access the bleeding risk between HD and PD patients. Bias risk were accessed by using The Newcastle-Ottawa Scale for cohort study. We performed analysis to provide pooled risk ratio (RR) with 95% confidence interval (CI) using fixed-effect heterogeneity test.
Results: We included 5 cohort studies that met our inclusion criteria. Patients undergoing HD have significant incremental upper gastrointestinal bleeding (GIB) risk compared with the PD patients (pooled RR = 1.24, 95% CI 1.12-1.37, p<0.0001, I2=0%). The overall bleeding risk also showed that HD patients have significantly increased bleeding risk when combined with other bleeding events, such as lower GIB and non-traumatic subdural haemorrhage (pooled RR = 1.27, 95% CI 1.16-1.38, p<0.00001, I2=0%). The antiplatelets administration slightly increase the bleeding risk among CKD patients although the result is no statistically significant (pooled RR = 1.05, 95% CI 0.87-1.26, p=0.60, I2=0%).
Conclusions: The HD patients have increased bleeding risk compared with PD patients and the antiplatelet use does not increase the bleeding risk among CKD patients. However, further studies are needed to establish the causalities.
To cite this abstract in AMA style:Putra BP, Putra FN. Incidence Comparison and The Antiplatelet Effect on Bleeding Risk Between Chronic Kidney Disease Undergoing Haemodialysis and Peritoneal Dialysis: A Meta-analysis of Cohort Studies [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/incidence-comparison-and-the-antiplatelet-effect-on-bleeding-risk-between-chronic-kidney-disease-undergoing-haemodialysis-and-peritoneal-dialysis-a-meta-analysis-of-cohort-studies/. Accessed September 16, 2021.
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