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Oral Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease

1
Department of Nephrology/Internal Medicine, Mures County Clinical Hospital, 540103 Târgu Mureș, Romania
2
Department of Pharmacology and Clinical Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
*
Author to whom correspondence should be addressed.
Academic Editor: Giuseppe Andò
Received: 20 March 2021 / Revised: 21 April 2021 / Accepted: 22 April 2021 / Published: 27 April 2021
(This article belongs to the Special Issue Guidelines, New Data and Real-World Evidence with Oral Anticoagulants)
Over the past few decades, a series of innovative medicines have been developed in order to optimize anticoagulation therapy for atrial fibrillation (AF). As a result, a number of nonvitamin K antagonist oral anticoagulants (NOAC) that directly target the enzymatic activity of factor II and factor Xa have been successfully licensed providing a more predictable effect and better safety profile compared to conventional anticoagulants (heparins and vitamin K antagonists (VKAs)). However, comparative efficacy and safety data is limited in patients with advanced chronic kidney disease (i.e., CKD stage 4/5 and end stage renal disease) because patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 were actively excluded from landmark trials, thus representing a major clinical limitation for the currently available agents. However, the renal function of AF patients can be altered over time. On the other hand, patients with CKD have an increased risk of developing AF. This review article will provide an overview of current concepts and recent evidence guiding the clinical use of NOACs in patients with CKD requiring chronic anticoagulation, and the associated risks and benefits of treatment in this specific patient population. View Full-Text
Keywords: oral anticoagulation; non-vitamin K oral anticoagulants; chronic kidney disease oral anticoagulation; non-vitamin K oral anticoagulants; chronic kidney disease
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MDPI and ACS Style

Stoica, M.C.; Gáll, Z.; Gliga, M.L.; Căldăraru, C.D.; Székely, O. Oral Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease. Medicina 2021, 57, 422. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050422

AMA Style

Stoica MC, Gáll Z, Gliga ML, Căldăraru CD, Székely O. Oral Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease. Medicina. 2021; 57(5):422. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050422

Chicago/Turabian Style

Stoica, Mihai C., Zsolt Gáll, Mirela L. Gliga, Carmen D. Căldăraru, and Orsolya Székely. 2021. "Oral Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease" Medicina 57, no. 5: 422. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050422

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