Background:

Anticoagulation in patients with chronic kidney disease is a therapeutic challenge since the medical evidence is scarce and the benefits are debatable since the risk of bleeding in these patients is greater.

Purpose:

To describe patients with G4-5 kidney disease who received oral anticoagulant therapy for at least 3 months in the central-eastern subnetwork of Bogotá.

Methodology:

Analytical study of patients with G4-5 chronic kidney disease, in a reference hospital between January 2018 and December 2021, in which sociodemographic and clinical variables were analyzed, and a logistic regression was performed on anticoagulants and the frequency of events (hemorrhagic or embolic).

Results:

75 anticoagulated patients diagnosed with G4-5 chronic kidney disease were evaluated. The most commonly used anticoagulant was warfarin (76%), apixaban (16%), and rivaroxaban (8%). Major bleeding occurred with warfarin (8.47%), apixaban (10%), and rivaroxaban (16.6%). There are no significant differences between major bleeding with warfarin (OR: 2.8; 95% CI: 0.46;16.9; p= 0.262), and rivaroxaban (OR: 1.86; 95% CI: 0.18;18.7; p=0.596). Clinically relevant non-major bleeding was 28.9% with warfarin. A thrombotic complication only occurred in one patient who received rivaroxaban.

Conclusions:

In patients with G4-5 kidney disease who received warfarin and direct oral anticoagulants, no significant differences were found in terms of the presentation of clinically relevant major and non-major bleeding.

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