Add like
Add dislike
Add to saved papers

Anticoagulation in chronic kidney disease: from guidelines to clinical practice.

BACKGROUND: Chronic kidney disease (CKD) is a major global public health problem, being closely connected to cardiovascular disease. CKD involves an elevated thromboembolic risk and requires anticoagulation, but the high rates of hemorrhage render it quite challenging.

HYPOTHESIS: There are no consensus recommendations regarding anticoagulation in CKD. Due to the currently limited data, clinicians need practical clues for monitoring and optimizing the treatment.

METHODS: Based on the available data, this review outlines the benefit-risk ratio of all types of anticoagulants in each stage of CKD and provides practical recommendations for accurate dosage adjustment, reversal of antithrombotic effect, and monitoring of renal function on a regular basis.

RESULTS: Evidence from randomized controlled trials supports the efficient and safe use of warfarin and direct oral anticoagulants (DOACs) in mild and moderate CKD. On the contrary, the data are poor and controversial for advanced stages. DOACs are preferred in CKD stages 1 to 3. In patients with stage 4 CKD, the choice of warfarin vs DOACs will take into consideration the pharmacokinetics of the drugs and patient characteristics. Warfarin remains the first-line treatment in end-stage renal disease, although in this case the decision to use or not to use anticoagulation is strictly individualized. Anticoagulation with heparins is safe in nondialysis-dependent CKD, but remains a challenge in the hemodialysis patients.

CONCLUSIONS: Although there is a need for cardiorenal consensus regarding anticoagulation in CKD, adequate selection of the anticoagulant type and careful monitoring are some extremely useful indications for overcoming management challenges.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app