Direct oral anticoagulants in chronic kidney disease: an update

Purpose of review Direct oral anticoagulants (DOACs) are variably eliminated by the kidneys rendering their use potentially problematic in patients with chronic kidney disease (CKD) or necessitating appropriate dose adjustment. Recent findings Both observational and limited randomized trial data for DOACs compared with no treatment or with warfarin for patients with atrial fibrillation on maintenance dialysis were recently published. In a randomized trial in patients on hemodialysis, there was no significant difference in vascular calcification between patients who received rivaroxaban with or without vitamin K2 or vitamin K antagonists. A randomized trial of apixaban versus warfarin was terminated owing to poor enrollment and preliminary results identified no difference in clinical outcomes between groups. However, valuable pharmacodynamic data will be forthcoming from that trial. In observational research, among patients newly diagnosed with atrial fibrillation, there were opposing trends in the associations of apixaban initiation versus no oral anticoagulation with ischemic versus hemorrhagic stroke and no association was present with the overall risk of stroke or embolism. In another study comparing apixaban with warfarin initiation, apixaban was associated with less bleeding. Regular-dose apixaban (5 mg twice daily) associated with reduced rates of ischemic stroke or systemic embolism, whereas no such association was present for those prescribed the reduced dose (...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Related Links:

This study compared stroke characteristics and poststroke care and disability between these groups.Stroke
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Neurology & Neurosurgery Journal Article Source Type: news
SUPPLEMENTS could be used to improve the health of your heart, as well as to protect against high blood pressure symptoms and signs. Add these cheap garlic capsules to your diet to lower your risk of heart problems, including heart attacks and heart disease.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Might HCV treatment have a role in mitigating the risk for developing chronic kidney disease among HIV/HCV co-infected individuals?AIDS
Source: Medscape Hiv-Aids Headlines - Category: Infectious Diseases Tags: HIV/AIDS Journal Article Source Type: news
Those suffering from cancer, heart conditions, strokes, diabetes and lung disease are among the worst affected by delays to their diagnosis and care, a survey of senior doctors reveals.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
HIGH blood pressure is a largely symptomless silent killer. If a person ignores their blood pressure because they think a certain symptom will alert them to the problem, they are taking a dangerous chance with their life. There are two waring signs which lay in a person's face.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Conclusions: Changing national guidelines with discard of contraindications for anticoagulation and the introduction of DOACs led to a broader recommendation of oral anticoagulation. However, both, new guidelines and DOACs, were not found to be associated with an increasing percentage of patients discharged from our hospital already on recommended anticoagulant prevention. This might be explained by the decreasing length of hospital stay during the study period and a missing evidence of early bleeding risk of DOACs in patients with acute brain infarction. Evidence-based data to close this therapeutic gap are needed.Cerebrovasc Dis
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
Conclusions: In our large cohort of CAS patients, coexistent UIAs are not uncommon. Stenting of a carotid artery in the presence of coexistent UIAs could be conducted safely. Together with 3-month dual antiplatelet therapy, CAS did not increase the rupture risk of the coexistent UIAs within 3 months.Cerebrovasc Dis
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
Date: Wednesday, 01 27, 2021; Speaker: Anastasios Pittas, M.D, Tufts Medical Center; 6100 Executive Boulevard; 3rd Floor Conference Room
Source: NIH Calendar of Events - Category: American Health Source Type: events
Publication date: Available online 3 August 2020Source: Stem Cell ResearchAuthor(s): Glen Lester Sequiera, Cheryl Rockman-Greenberg, Sanjiv Dhingra
Source: Stem Cell Research - Category: Stem Cells Source Type: research
Publication date: Available online 4 August 2020Source: Journal of Psychiatric ResearchAuthor(s): Favaz Vellekkatt, Vikas Menon, Medha Rajappa, Jayaprakash Sahoo
Source: Journal of Psychiatric Research - Category: Psychiatry Source Type: research
More News: Atrial Fibrillation | Bleeding | Chronic Kidney Disease | Coumadin | Dialysis | Drugs & Pharmacology | Hemodialysis | Hemorrhagic Stroke | Hypertension | Ischemic Stroke | Stroke | Study | Urology & Nephrology | Vitamin K | Vitamins | Warfarin