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논문분류	춘계학술대회 초록집
제목	Relationship Between Renal Biomarkers And Bleeding Risk In Chronic Kidney Disease And Atrial Fibrillation
저자	Ranokhon Igamberdieva
출판정보	2026; 2026(1):
키워드	chronic kidney disease , atrial fibrillation , kidney damage markers , hemorrhagic complications , anticoagulant therapy
초록	Objectives: The aim was to evaluate the potential relationship between the occurrence of bleeding and urinary markers of kidney damage in patients with chronic kidney disease (CKD) and atrial fibrillation (AF) receiving rivaroxaban. Methods: The study included 266 patients (65-97 years old) receiving rivaroxaban at a dose of 15 mg or 20 mg per day depending on the glomerular filtration rate: 140 patients with AF+CKD C3a and 126 patients with AF+CKD C3b, C4. The control group included 90 healthy volunteers. A retrospective risk assessment was performed using the HAS-BLED scale, the presence of bleeding according to the ISTH, and an analysis of the excretion of kidney damage markers (albumin; nephrin; neutrophil gelatinase-associated lipocalin (NGAL); kidney injury molecule-1 (KIM-1)) in urine. Results: Patients were divided into groups according to the risk of bleeding: 92 patients had a risk score of ≥1 point (group 1); 174 patients had 0 points (group 2). Bruises were recorded in 52 patients (19%), nosebleeds in 22 patients (8.3%), bleeding from minor wounds in 12 patients (4.3%), muscle hematomas in 6 patients (2.2%), bleeding from the oral cavity in 6 patients (2.2%), and hemorrhoidal bleeding in 2 patients (0.75%). Urinary NGAL and KIM-1 levels in patients with AF and CKD in group 1 (5.6ng/ml and 0.69ng/ml, respectively) were statistically significantly higher compared to patients in group 2 (4.2ng/ml (p=0.039) and 0.39ng/ml (p=0.019, Table 1)). 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.
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