Original Article
Analysis of risk factors for coagulation events in patients receiving argatroban during renal replacement therapy
Tang Lian, Zhou Mengyue, Zhuang Zhiwei, Lu Jian, Shen Yi, Xu Xiaowen, Zhou Qin, Xue Sudong, Yu Yanxia
Published 2019-08-28
Cite as ADRJ, 2019,21(4): 258-264. DOI: 10.3760/cma.j.issn.1008-5734.2019.04.004
Abstract
ObjectiveTo explore the risk factors for coagulation events after argatroban anticoagulation in patients receiving renal replacement therapy (RRT).
MethodsThe medical records of patients at high risk of bleeding, who received RRT combined with argatroban anticoagulation in ICU of the Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital) from January 2015 to March 2017, were collected and analyzed retrospectively.
ResultsA total of 65 patients were enrolled, including 36 males and 29 females, aged (75.4±19.7) years. A total of 372 RRT cycles were performed, including 72 cycles in the coagulation events group because of coagulation events occurence and the remaining 300 cycles in the non-coagulation events group. Univariate logistic regression analysis showed that platelet count (OR=0.990, 95%CI: 0.978-1.001, P=0.084) and serum calcium level at the time of finishing RRT (OR=5.722, 95%CI: 2.183-14.999, P<0.001), first dose (OR=0.712, 95%CI: 0.498-1.017, P=0.062), initial micropump dosage (OR=0.614, 95%CI: 0.368-1.026, P=0.063), and adjusted micropump dosage(OR=0.587, 95%CI: 0.353-0.977, P=0.040) of argatroban, and transmembrane pressure at the time of finishing RRT (OR=1.010, 95%CI: 1.006-1.014, P<0.001) were associated with coagulation events. Multivariate logistic regression analysis showed that serum calcium level and transmembrane pressure at the time of finishing RRT were independent risk factors of coagulation events (OR=4.007, 95%CI: 1.107-15.793, P=0.047; OR=1.012, 95%CI: 1.005-1.018, P=0.008). The ROC curve showed that the risk of coagulation events increased when serum calcium level at the time of finishing RRT was more than 2.6 mmol/L or transmembrane pressure at the time of finishing RRT was more than 206 mmHg.
ConclusionSerum calcium level and transmembrane pressure at the time of finishing RRT are independent risk factors of coagulation events after argatroban anticoagulation during RRT.
Key words:
Anticoagulants; Hemofiltration; Risk factors; Argatroban; Renal replacement therapy
Contributor Information
Tang Lian
Department of Pharmacy, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Zhou Mengyue
Colleage of Pharmacy, Xuzhou Medical University, Xuzhou 221004, China
Zhuang Zhiwei
Intensive Care Unit, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Lu Jian
Intensive Care Unit, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Shen Yi
Intensive Care Unit, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Xu Xiaowen
Intensive Care Unit, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Zhou Qin
Department of Pharmacy, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Xue Sudong
Department of Pharmacy, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China
Yu Yanxia
Department of Pharmacy, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215002, China