The use of direct oral anticoagulants in chronic kidney disease.

Abstract:

:Increasing use of direct oral anticoagulants (DOACs) has made management of non-valvular atrial fibrillation and venous thromboembolism easier in most patients. But the presence of co-existing renal impairment could render the use of DOACs problematic because all of these drugs have varying degrees of renal excretion. In this paper we address misconceptions about the safety and efficacy of DOACs in moderate-severe renal impairment by presenting a summary of the literature from phase III trials and real-world studies. It also addresses the important consideration of correct estimate of renal function for DOAC dosing. It is hoped that the review will serve as a valuable resource for clinicians involved in anticoagulation decision-making in patients with renal impairment to guide the choice of most suitable agent. Accurate dosing is of particular relevance as registry data suggests it is done inconsistently and may be resulting in avoidable thromboembolic and bleeding events.

journal_name

Br J Haematol

authors

Parker K,Thachil J

doi

10.1111/bjh.15564

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

170-184

issue

2

eissn

0007-1048

issn

1365-2141

journal_volume

183

pub_type

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