Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease.
CKD
DOAC
ESRD
anticoagulation
chronic kidney disease
direct oral anticoagulants
end-stage renal disease
hemodialysis
Journal
International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455
Informations de publication
Date de publication:
27 01 2022
27 01 2022
Historique:
received:
09
01
2022
revised:
23
01
2022
accepted:
24
01
2022
entrez:
15
2
2022
pubmed:
16
2
2022
medline:
1
3
2022
Statut:
epublish
Résumé
The prevalence of chronic kidney disease (CKD) is increasing due to the aging of the population and multiplication of risk factors, such as hypertension, arteriosclerosis and obesity. Impaired renal function increases both the risk of bleeding and thrombosis. There are two groups of orally administered drugs to prevent thromboembolic events in patients with CKD who require anticoagulation: vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs). Although VKAs remain the first-line treatment in patients with advanced CKD, treatment with VKAs is challenging due to difficulties in maintaining the appropriate anticoagulation level, tendency to accelerate vascular calcification and faster progression of CKD in patients treated with VKAs. On the other hand, the pleiotropic effect of DOACs, including vascular protection and anti-inflammatory properties along with comparable efficacy and safety of treatment with DOACs, compared to VKAs observed in preliminary reports encourages the use of DOACs in patients with CKD. This review summarizes the available data on the efficacy and safety of DOACs in patients with CKD and provides recommendations regarding the choice of the optimal drug and dosage depending on the CKD stage.
Identifiants
pubmed: 35162472
pii: ijerph19031436
doi: 10.3390/ijerph19031436
pmc: PMC8835601
pii:
doi:
Substances chimiques
Anticoagulants
0
Vitamin K
12001-79-5
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
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