Methods: The study included 266 patients aged 65 to 97 years: 140 patients with AF in combination with CKD C3a (102 women -102 (71. 8%) ) and 126 patients with AF in combination with CKD C3b and 4 (90 women (71%) ). Patients took rivaroxaban at a dosage of 15 mg or 20 mg once a day, depending on the glomerular filtration rate. All patients underwent a retrospective assessment of the presence of bleeding according to the HAS-BLED scale, analysis of the excretion of markers of renal injury (albumin; nephrin; neutrophil gelatinase-associated lipocalin (NGAL) ; kidney injury molecule-1 (KIM-1) ) with urine. Additionally, an analysis of the level of markers of renal damage in the urine of 90 healthy volunteers was performed. Results: According to the risk of bleeding, patients were divided into 2 groups: Group 1 included patients with 1 point (92 patients (34. 8%), average age 80. 7 years). Group 2 included patients with 0 points: 174 patients (65. 2%), average age 78. 2 years. Of the bleeding, bruises were common in 52 patients (19%), nosebleeds were found in 22 patients (8. 3%), bleeding from minor wounds was noted in 12 patients (4. 3%), muscle hematomas were found in 6 patients (2. 2%), bleeding from the oral cavity was found in 6 patients (2. 2%), and hemorrhoidal bleeding was diagnosed in 2 patients (0. 75%). The levels of NGAL and KIM-1 in urine in patients with AF and CKD in group 1 (5. 6 ng/ml and 0. 69 ng/ ml, respectively) were statistically significantly higher compared to patients in group 2 (4. 2 ng/ml (p=0. 039) and 0. 39 ng/ml (p=0. 019). Conclusion: Our study results indicate the presence of a statistically significant association between the presence of bleeding in patients with AF and CKD stages 3-4 receiving rivaroxaban with the level of tubular damage markers KIM-1 and NGAL in urine. I have no potential conflict of interest to disclose. I did not use generative AI and AI-assisted technologies in the writing process.
Yanagita et al. (Wed,) studied this question.