Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and End Stage Renal Disease

Over the last decade there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) demonstrated favorable clinical outcomes compared to warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) is a particularly complex issue. CKD and ESRD increase both the risk of stroke as well as bleeding, and since all of the NOACs undergo various level of renal clearance, renal dysfunction inevitably effects the pharmacokinetics of the drug in each patient.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research