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Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease
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 administe...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8835601/ https://www.ncbi.nlm.nih.gov/pubmed/35162472 http://dx.doi.org/10.3390/ijerph19031436 |
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author | Rogula, Sylwester Gąsecka, Aleksandra Mazurek, Tomasz Navarese, Eliano Pio Szarpak, Łukasz Filipiak, Krzysztof J. |
author_facet | Rogula, Sylwester Gąsecka, Aleksandra Mazurek, Tomasz Navarese, Eliano Pio Szarpak, Łukasz Filipiak, Krzysztof J. |
author_sort | Rogula, Sylwester |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8835601 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88356012022-02-12 Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease Rogula, Sylwester Gąsecka, Aleksandra Mazurek, Tomasz Navarese, Eliano Pio Szarpak, Łukasz Filipiak, Krzysztof J. Int J Environ Res Public Health Review 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. MDPI 2022-01-27 /pmc/articles/PMC8835601/ /pubmed/35162472 http://dx.doi.org/10.3390/ijerph19031436 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Rogula, Sylwester Gąsecka, Aleksandra Mazurek, Tomasz Navarese, Eliano Pio Szarpak, Łukasz Filipiak, Krzysztof J. Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease |
title | Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease |
title_full | Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease |
title_fullStr | Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease |
title_full_unstemmed | Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease |
title_short | Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease |
title_sort | safety and efficacy of doacs in patients with advanced and end-stage renal disease |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8835601/ https://www.ncbi.nlm.nih.gov/pubmed/35162472 http://dx.doi.org/10.3390/ijerph19031436 |
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