Safety of New Oral Anticoagulants for Patients with Chronic Kidney Disease

Curr Pharm Des. 2018;24(38):4505-4510. doi: 10.2174/1381612825666190130144051.

Abstract

In daily practice, chemical substances called "direct oral anticoagulants" or DOACs are more convenient to administer when set beside vitamin K antagonists (VKA) due to improved pharmacologic properties, fewer drug interactions and rapid onset of action. The objective of this review was to assess whether DOACs are the alternative for VKA in subjects with mild-to-moderate chronic kidney disease (CKD). An analysis of current DOAC trials and studies was performed focusing on subjects with CKD. This review concludes that although DOACS are not recommended in the course of advanced chronic kidney disease (CrCl<30mL/min) or during dialysis, DOACS are a reasonable choice for individuals with mild to moderate CKD.

Keywords: Anticoagulants; chronic kidney disease; dialysis; direct oral anticoagulants; pharmacologic properties; vitamin K antagonists..

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects*
  • Anticoagulants / pharmacokinetics
  • Anticoagulants / therapeutic use
  • Hemorrhage / blood
  • Hemorrhage / chemically induced*
  • Humans
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / drug therapy*
  • Stroke / blood
  • Stroke / prevention & control
  • Venous Thrombosis / blood
  • Venous Thrombosis / prevention & control
  • Vitamin K / antagonists & inhibitors*

Substances

  • Anticoagulants
  • Vitamin K