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Position paper on the safety/efficacy profile of direct oral anticoagulants in patients with chronic kidney disease. Consensus document from the SIN, FCSA and SISET
- Source :
- Blood Transfus
- Publication Year :
- 2020
- Publisher :
- NLM (Medline), 2020.
-
Abstract
- Direct oral anticoagulants (DOAC) are mostly prescribed to prevent cardioembolic stroke in patients with non-valvular atrial fibrillation (AF). An increasing number of guidelines recommend DOAC in AF patients with preserved renal function for the prevention of thromboembolism, and an increased use of DOAC in daily practice has been recorded also in elderly patients. Ageing is associated with a reduction in glomerular filtration rate, and impaired renal function, regardless of the cause, increases the risk of bleeding. Multiple medication use (polypharmacy) for treating superimposed co-morbidities is common in both elderly and chronic kidney disease (CKD) patients and drug-drug interaction may cause accumulation of DOAC, thereby increasing the risk of bleeding. The safety profile of DOAC in patients with CKD has not been defined with any certainty, particularly in those with severely impaired renal function or end stage renal disease. This has been due to the heterogeneity of studies and the relative paucity of data. This document reports the position of three Italian scientific societies engaged in the management of patients with atrial fibrillation who are treated with DOAC and present with CKD.
- Subjects :
- Metabolic Clearance Rate
Pyridines
Pyridones
Direct anticoagulants, chronic kidney disease, stroke, bleeding
Antidotes
Administration, Oral
Hemorrhage
urologic and male genital diseases
Kidney
Antithrombins
Haemostasis and Thrombosis
Cohort Studies
Rivaroxaban
Atrial Fibrillation
Humans
Drug Interactions
Renal Insufficiency, Chronic
Randomized Controlled Trials as Topic
Dabigatran
Stroke
Observational Studies as Topic
Thiazoles
Practice Guidelines as Topic
Polypharmacy
Pyrazoles
Drug Monitoring
Glomerular Filtration Rate
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Blood Transfus
- Accession number :
- edsair.pmid.dedup....4551c4207e88522706202d500c8078b0