Back to Search
Start Over
Safety and effectiveness of rivaroxaban and warfarin in moderate-to-advanced CKD: real world data.
- Source :
-
Journal of nephrology [J Nephrol] 2018 Oct; Vol. 31 (5), pp. 751-756. Date of Electronic Publication: 2018 Jun 07. - Publication Year :
- 2018
-
Abstract
- Background: In recent years, novel anticoagulant drugs have been introduced in the clinical armamentarium and have progressively gained momentum. Although their use is increasing among CKD patients, some skepticism about their risk-benefit ratio still persists. We sought to investigate the safety and effectiveness of rivaroxaban in a cohort of moderate-to-advanced CKD patients.<br />Methods: This observational, retrospective, longitudinal study involved 347 consecutive CKD stage 3b-4 (according to NKF-KDOQI guidelines) patients enrolled from 8 cardiac outpatient clinics between March 2015 and October 2017. All patients received anticoagulation (100 warfarin vs. 247 rivaroxaban) as part of their non-valvular atrial fibrillation management at the attending physician's discretion. Clinical effectiveness (defined as the occurrence of ischemic stroke, venous thromboembolism, or transient ischemic attack) and safety (intracranial hemorrhage, gastrointestinal or other bleeding) were assessed separately.<br />Results: Over a mean follow-up period of 16 ± 0.3 months, 25 stroke episodes (15 hemorrhagic, and 10 ischemic) occurred in 24 warfarin treated patients vs. none in the rivaroxaban arm. There were 5 vs. 0 episodes of deep venous thrombosis and 8 vs. 2 major episodes of bleeding in the warfarin and rivaroxaban groups, respectively. In contrast, the proportion of minor episodes of bleeding was similar between groups.<br />Conclusion: Rivaroxaban seems a safe and effective therapeutic option in CKD stage 3b-4 patients. However, future randomized controlled trials are needed to definitively establish the role of rivaroxaban in CKD patients.
- Subjects :
- Aged
Anticoagulants adverse effects
Atrial Fibrillation complications
Atrial Fibrillation diagnosis
Cerebrovascular Disorders diagnosis
Cerebrovascular Disorders etiology
Factor Xa Inhibitors adverse effects
Female
Hemorrhage chemically induced
Humans
Italy
Longitudinal Studies
Male
Middle Aged
Renal Insufficiency, Chronic diagnosis
Renal Insufficiency, Chronic physiopathology
Retrospective Studies
Risk Assessment
Risk Factors
Rivaroxaban adverse effects
Time Factors
Treatment Outcome
Warfarin adverse effects
Anticoagulants administration & dosage
Atrial Fibrillation drug therapy
Cerebrovascular Disorders prevention & control
Factor Xa Inhibitors administration & dosage
Renal Insufficiency, Chronic complications
Rivaroxaban administration & dosage
Warfarin administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1724-6059
- Volume :
- 31
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 29882198
- Full Text :
- https://doi.org/10.1007/s40620-018-0501-7