Study: 20% of patients with kidney disease, no Medicare used antiplatelets on dialysis
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Researchers found one-fifth of patients with kidney disease who do not have Medicare have used an antiplatelet and/or anticoagulant during hemodialysis, according to data published in Kidney Medicine.
“Although some studies indicate that anticoagulants reduce stroke, mortality, and thromboembolism without an increase in bleeding, others indicate that anticoagulants do not decrease mortality rates or risk of stroke in these patients and may increase bleeding,” Robert Boggs, PhD, and colleagues wrote in their research letter. They added, “... the objective of this retrospective observational cohort study was to assess the use of anticoagulants and antiplatelets among U.S. patients with kidney failure receiving hemodialysis who do not have primary insurance coverage through Medicare.”
In a retrospective claims-based study, researchers examined data of 7,400 patients (mean age was 54.5 years; 64.2% were men) initiating hemodialysis between 2014 and 2018. Administrative claim data were derived from the Optum Clinformatics Data Mart commercial database.
Of the 1,495 patients in the study who were on dialysis while receiving an anticoagulant and/or antiplatelet, 12% used antiplatelets, 8% used warfarin and 3% used direct oral anticoagulants.
Researchers suggest that a small ratio of patients stopped anticoagulants/antiplatelets after initiating hemodialysis because although 20.2% patients were administered treatment after hemodialysis, 23.2% filled a prescription during the full study period, which includes the time before dialysis initiation.
Overall, one-fifth of patients with kidney disease and without Medicare were being administered an antiplatelet and/or anticoagulant while receiving hemodialysis.
Researchers noted that the study is limited to 30 months of follow-up because of the Medicare transition period.
“Our study also found that more than half of patients with atrial fibrillation used an antiplatelet and/or anticoagulant after initiating hemodialysis,” Boggs and colleagues wrote. “More research is warranted to understand the risk-benefit profile of anticoagulants and antiplatelets in treating patients with kidney failure receiving hemodialysis.”
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