Abstract:
PURPOSE OF REVIEW:The direct oral anticoagulants (DOACs) have emerged as an effective and safe alternative to vitamin K antagonists (VKAs) for stroke and venous thromboembolism (VTE) prevention. However, patients with chronic kidney disease (CKD) experience an increase in the risk of both thromboembolism and bleeding, and the risk-benefit profile of DOACs, particularly in advanced CKD remains a source of ongoing debate. This review summarizes the recent evidence on the effects of DOACs in CKD across a range of clinical indications including newly emerging indications. RECENT FINDINGS:Data on early-to-moderate stage CKD derived from pivotal randomized controlled trials in broader atrial fibrillation and VTE populations support the favorable risk-benefit ratio of DOACs compared with VKAs in patients in these groups. However, safety data from observational studies comparing DOACs with VKAs in patients with atrial fibrillation and CKD (moderate to advanced) have been conflicting. Recent trials have evaluated the efficacy of low-dose DOACs on major cardiovascular outcomes, showing promising risk-benefit ratios in high-risk populations with concurrent CKD. SUMMARY:Current data on patients with CKD derived from trials in the broader population suggest that DOACs are an effective alternative to VKAs in patients with early-to-moderate stage CKD. However, studies on patients with advanced CKD are lacking. Further randomized controlled trials, particularly those evaluating the risk of any clinically relevant bleeding as part of a more accurate assessment of the risk-benefit profile of DOACs in people with CKD, are needed.
journal_name
Curr Opin Nephrol Hypertensjournal_title
Current opinion in nephrology and hypertensionauthors
Ha JT,Badve SV,Jun Mdoi
10.1097/MNH.0000000000000493subject
Has Abstractpub_date
2019-05-01 00:00:00pages
251-261issue
3eissn
1062-4821issn
1473-6543journal_volume
28pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Patients with chronic kidney disease (CKD) endure compromised health-related quality of life (HRQOL). Although the link between HRQOL and increased mortality in patients with end-stage renal disease (ESRD) is well documented, less is known about the relationship between CKD and HRQOL. This article rev...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328335f939
更新日期:2010-03-01 00:00:00
abstract::Growth hormone and a number of polypeptide growth factors exert actions on renal development, growth, and metabolism and on repair processes following renal injury. There is increasing evidence that under selected circumstances, these agents play roles in the pathogenesis of kidney disease and that under others, they ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199301000-00010
更新日期:1993-01-01 00:00:00
abstract::After renal transplantation, acute allograft dysfunction secondary to acute rejection occurs in around 30-40% of patients. Although in the majority of patients these episodes are reversible, acute rejection remains a major risk factor for the development of chronic rejection. Remarkably, prior episodes of acute allogr...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199911000-00013
更新日期:1999-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Emerging evidence supports an important role for the heme oxygenase system in the maintenance of a healthy pregnancy. This review attempts to collect these wide-ranging data and summarize the recent progress in the field. RECENT FINDINGS:New studies looking at heme oxygenase depletion in a variety of...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32835d19f7
更新日期:2013-03-01 00:00:00
abstract:PURPOSE OF THIS REVIEW:The purpose of this review is to explain the rationale and limitations for use of mineralocorticoid receptor blockers (MRBs) for the treatment of chronic kidney disease (CKD) and its complications. RECENT FINDINGS:Recent studies in animal models of CKD demonstrate that blockade of the mineraloco...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32833ce6d5
更新日期:2010-09-01 00:00:00
abstract:PURPOSE OF REVIEW:microRNAs (miRNAs) are short noncoding RNAs that function as sequence-specific inhibitors of gene expression. Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent genetic cause of end-stage kidney failure with limited treatment options. The realization that miRNA upregulation, and...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000333
更新日期:2017-07-01 00:00:00
abstract:PURPOSE OF REVIEW:This article will review briefly the emerging new concepts in the diagnosis and treatment of myocardial fibrosis in patients with hypertensive heart disease. RECENT FINDINGS:Although hypertensive heart disease is characterized clinically by development of left-ventricular hypertrophy in the absence o...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000174143.30045.bd
更新日期:2005-09-01 00:00:00
abstract::The characteristic structure of polarized proximal tubule cells is drastically altered by the onset of ischemic acute renal failure. Distinctive apical brush border microvilli disruption occurs rapidly and in a duration-dependent fashion. Microvillar membranes internalize into the cytosol of the cell or are shed into ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 社论,评审
doi:10.1097/00041552-199907000-00009
更新日期:1999-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The nephrology community lacks a unified view of protein sieving through the glomerular capillary wall. The glomerular capillary wall consists of three distinct but closely interacting layers: the fenestrated endothelium, with its glycocalyx; the podocytes, with their interdigitated foot processes and...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/mnh.0b013e3283296044
更新日期:2009-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Inflammatory cytokines contribute to the pathogenesis of hypertension through effects on renal blood flow and sodium handling. This review will update recent advances that explore the renal actions of immune cells and cytokines in the pathogenesis of hypertension. RECENT FINDINGS:Populations of cells...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000385
更新日期:2018-03-01 00:00:00
abstract::Heat shock proteins, or stress proteins, are molecular chaperones responsible for protein processing and protection against cellular injury through the prevention of inappropriate peptide interactions. The distribution of individual stress proteins varies between regions of the kidney and within subcellular compartmen...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199807000-00010
更新日期:1998-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim is to review data on the epidemiology of fibroblast growth factor 23 (FGF23) and adverse clinical outcomes in chronic kidney disease (CKD) and introduce recent insights into the pathophysiology behind the observed relationships. RECENT FINDINGS:End-stage renal disease and cardiovascular disea...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328351a391
更新日期:2012-05-01 00:00:00
abstract:PURPOSE OF REVIEW:There is much interest in cystatin C to replace or supplement serum creatinine to estimate the glomerular filtration rate (GFR). Here we review the performance of cystatin C and combined creatinine-cystatin C estimating equations compared to creatinine-based estimating equations in chronic and acute k...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834b8850
更新日期:2011-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Studies of patients with tumors associated with osteomalacia (tumor-induced osteomalacia), X-linked hypophosphatemia (XLH) and autosomal-dominant hypophosphatemic rickets have provided important new insights into the identity and mechanisms of action of factors that play a role in controlling renal ph...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200209000-00011
更新日期:2002-09-01 00:00:00
abstract::The cells of the renal medulla osmotically adapt to chronic alterations in extracellular tonicity by appropriate changes in the intracellular contents of organic osmoeffectors. The major organic osmolytes are glycerophosphorylcholine, betaine, myo-inositol, sorbitol, and, possibly, taurine. When the concentrations of ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199210000-00007
更新日期:1992-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Skin autofluorescence (SAF) is a measure of the accumulation of advanced glycation end-products (AGEs) proposed to act as a marker of 'cumulative metabolic stress'. This article discusses mechanisms of AGE formation and reviews published literature on SAF as a biomarker and risk factor across the spec...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000549
更新日期:2019-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Arterial stiffness due to alterations in extracellular matrix is one of the mechanisms responsible for increased peripheral resistance in hypertension. Recent evidence points to arterial stiffness as an independent predictor of cardiovascular events. This review focuses on recent advances in the biolo...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328335eec9
更新日期:2010-03-01 00:00:00
abstract::The prevalence of hypertension is extremely high in end-stage renal disease, and is a probable contributor to the epidemic of cardiovascular disease in end-stage renal disease. However, the paucity of prospective, randomized clinical trials makes it difficult to precisely define treatment strategies. Therefore, at pre...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200005000-00012
更新日期:2000-05-01 00:00:00
abstract::Overexpression of the cytokine transforming growth factor-beta has been identified as the key mediator of chronic progressive kidney fibrosis in experimental and human kidney diseases. The renoprotective effects of angiotensin II blockade and low-protein diets have recently been linked to downregulation of transformin...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199707000-00014
更新日期:1997-07-01 00:00:00
abstract:PURPOSE OF REVIEW:There is currently a major debate on the mechanisms of albuminuria, and this review appraises recent studies in this area. RECENT FINDINGS:The traditional view of albuminuria is that it is the result of damage to an essentially impermeable glomerular barrier. However, over the years, critical evidenc...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32832cb96a
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The discovery of the extracellular calcium-sensing receptor, CasR has broadened our understanding of calcium homeostasis and led to the development of new pharmacological agents, calcimimetics, for treating hyperparathyroidism. In the present review, I discuss the function of CasR as well as provide e...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200307000-00002
更新日期:2003-07-01 00:00:00
abstract::The possible association between low-level lead exposure and blood pressure and the causal nature of any such relationship continue to be debated. A recent meta-analysis of the human model data showed that on average a doubling of blood lead was associated with a rise in blood pressure averaging 1 mm Hg systolic and 0...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199405000-00005
更新日期:1994-05-01 00:00:00
abstract::It is well known that hyperparathyroidism begins early in renal failure and progresses, probably not linearly, throughout the natural course of renal diseases and dialysis therapy. Recent progress in basic medical science has improved our understanding of the mechanisms by which the classically known stimuli for parat...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199607000-00007
更新日期:1996-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Potassium channels in the distal nephron are precisely controlled to regulate potassium secretion in accord with physiological demands. In recent years, it has become evident that membrane trafficking processes play a fundamental role. This short review highlights recent developments in elucidating th...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328363ff76
更新日期:2013-09-01 00:00:00
abstract::The vasculature wall is an active, integrated organ composed of endothelial cells and vascular smooth muscle cells, as well as other cell types depending on the specific vascular segment (e.g. fibroblasts in many vascular regions). The vascular wall is not static; the vascular components (cells and extracellular matri...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199701000-00016
更新日期:1997-01-01 00:00:00
abstract::There is ample evidence to support the recommendation of renin-angiotensin system blockade therapy as the standard of care for strategies aimed at preserving renal function in chronic renal disease. Nevertheless, despite the well established antihypertensive effects of these drugs, the use of renin-angiotensin system ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200201000-00001
更新日期:2002-01-01 00:00:00
abstract::Sodium restriction is the most commonly used lifestyle modification for control of hypertension. Nevertheless, there is no consensus on the relative importance of salt in the development of hypertension, nor is the physiological mechanism(s) responsible for salt-induced elevations of blood pressure clearly understood....
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199603000-00012
更新日期:1996-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite advances in hemodialysis technology, a stable and well functioning vascular access remains the bane of every hemodialysis patient. It is recognized that vascular access contributes to cardiovascular disease mortality through a number of mechanisms. This review describes the relationship betwee...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000247506.79538.3e
更新日期:2006-11-01 00:00:00
abstract::Substantial evidence indicates that the adverse effects of hypertension on the kidney depend on the degree to which systemic blood pressure elevations are transmitted to the renal microvasculature. Such blood pressure transmission and consequent susceptibility to hypertensive renal damage is markedly exacerbated in st...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200201000-00011
更新日期:2002-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The glomerular filtration barrier is a unique structure characterized by a specialized three-dimensional framework of podocytes. This review is aimed at describing the latest advances made in the understanding of polarity signalling pathways regulating the formation and the maintenance of the complex ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32832e316d
更新日期:2009-07-01 00:00:00