Abstract:
BACKGROUND:There is a higher risk of gastrointestinal (GI) bleeding in patients treated with dabigatran versus warfarin. We analyzed the impact of renal function on the relative risk of bleeding in patients converted to dabigatran. METHODS:Patients aged ≥65 years who received anticoagulation with warfarin for a minimum of 6 months and subsequently converted to dabigatran or remained on warfarin were studied. Data sources included VA National Patient Care, and VA Decision Support System National Pharmacy and Laboratory. Each patient who converted to dabigatran 150 mg twice daily was matched by propensity score with 2 patients on warfarin who did not convert. Outcomes included rates of hospital admission for GI or other major bleeding and mortality, stratified by estimated glomerular filtration rate (eGFR). RESULTS:Study population included 864 patients who converted and 1,710 patients who did not convert to dabigatran. In patients with eGFR 50-80 ml/min/1.73 m², the hazard of GI bleeding in patients who initiated dabigatran was nearly 3 times higher, (4.1 vs. 1.3 per 100 patient years; hazards ratio 2.94; 95% CI 1.24-7.02; p = 0.015), compared to patients who remained on warfarin. There were relatively few patients with eGFR <50 or >80 ml/min/1.73 m2, and relatively few bleeding events outside the GI tract. CONCLUSIONS:Prescribing healthcare providers should exercise caution and close monitoring for bleeding complications when converting from warfarin to dabigatran, even in patients with renal function in the range considered safe for dabigatran use as per current recommendations.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Kalil RS,Kaboli PJ,Liu X,Vaughan-Sarrazin Mdoi
10.1159/000446848subject
Has Abstractpub_date
2016-01-01 00:00:00pages
11-8issue
1eissn
0250-8095issn
1421-9670pii
000446848journal_volume
44pub_type
杂志文章abstract:BACKGROUND:While the etiology of idiopathic nephrotic syndrome (idiopathic nephrotic syndrome [INS]; characterized by repeated relapses and comorbid allergic conditions) remains unknown, recent evidence suggests that dysfunction in regulatory T cells (Tregs) plays an important role in the development of INS as well as ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487557
更新日期:2018-01-01 00:00:00
abstract::During the period from April 4, 1988, to April 20, 1988, nine pyrogenic reactions and five gram-negative bacteremias occurred in 11 patients undergoing dialysis. All pyrogenic reactions and gram-negative bacteremias occurred among patients in whom a reprocessed dialyzer was used. The rate of pyrogenic reactions or bac...
journal_title:American journal of nephrology
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更新日期:2018-01-01 00:00:00
abstract::Left ventricular hypertrophy (LVH) is a common finding in hypertensive autosomal dominant polycystic kidney disease (ADPKD) patients. There are few studies on the influence of blood pressure (BP) and nonhemodynamic factors on LVH in these patients. The aim of this study was to evaluate the relationship between BP, hum...
journal_title:American journal of nephrology
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abstract:BACKGROUND:The proinflammatory cytokine S100A12 (also known as EN-RAGE) is associated with cardiovascular morbidity and mortality in hemodialysis patients. In the current study, we tested the hypothesis that S100A12 expressed in vascular smooth muscle in nonatherosclerosis-prone C57BL/6J mice on normal rodent chow diet...
journal_title:American journal of nephrology
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013380
更新日期:1998-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,评审
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更新日期:2010-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-01-01 00:00:00
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更新日期:1981-01-01 00:00:00
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更新日期:2011-01-01 00:00:00
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更新日期:2002-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,评审
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
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更新日期:1999-01-01 00:00:00
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journal_title:American journal of nephrology
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更新日期:1983-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1159/000151770
更新日期:2009-01-01 00:00:00
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journal_title:American journal of nephrology
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更新日期:2016-01-01 00:00:00
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journal_title:American journal of nephrology
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doi:10.1159/000357788
更新日期:2014-01-01 00:00:00
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journal_title:American journal of nephrology
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doi:10.1159/000111387
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pub_type: 杂志文章
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journal_title:American journal of nephrology
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更新日期:2020-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168476
更新日期:1992-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000105125
更新日期:2007-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
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更新日期:2014-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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journal_title:American journal of nephrology
pub_type: 杂志文章
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journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000448766
更新日期:2016-01-01 00:00:00