<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Chronic kidney disease (CKD) affects over 10% of the global population and is more prevalent in the elderly, females, patients with diabetes or hypertension, and certain racial minorities. CKD is a leading cause of mortality, especially in CKD stage G5 and End-Stage Renal Disease (ESRD). Left ventricular hypertrophy (LVH) is common in CKD patients, predicting mortality even in early stages. CKD patients face a higher risk of bleeding, with a 3.5 times higher risk in hemodialysis patients. Atrial fibrillation (AF) and acute coronary syndrome are more prevalent in patients with eGFR &lt;60 ml/min, and the risk of pulmonary embolism increases by 25-30% regardless of CKD stage. Antithrombotic treatment is crucial for CKD patients with cardiovascular diseases. In early stages (G1-G3), both warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) can be used, with NOACs preferred due to their safety profile. In advanced stages (G4-G5) and ESRD (G5D), warfarin is commonly used, with reduced NOAC doses as an option. NOACs require careful monitoring of renal function, and hemodialysis can remove a significant portion of plasma dabigatran. Monitoring renal function is vital for CKD patients receiving NOACs. Some studies suggest NOACs may have a lower risk of cardiovascular events compared to warfarin, but conflicting data exist regarding bleeding risk. Individualized treatment decisions should consider the patient's renal function.</p>
</abstract>

Chronic kidney disease (CKD) affects over 10% of the global population and is more prevalent in the elderly, females, patients with diabetes or hypertension, and certain racial minorities. CKD is a leading cause of mortality, especially in CKD stage G5 and End-Stage Renal Disease (ESRD). Left ventricular hypertrophy (LVH) is common in CKD patients, predicting mortality even in early stages. CKD patients face a higher risk of bleeding, with a 3.5 times higher risk in hemodialysis patients. Atrial fibrillation (AF) and acute coronary syndrome are more prevalent in patients with eGFR <60 ml/min, and the risk of pulmonary embolism increases by 25-30% regardless of CKD stage. Antithrombotic treatment is crucial for CKD patients with cardiovascular diseases. In early stages (G1-G3), both warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) can be used, with NOACs preferred due to their safety profile. In advanced stages (G4-G5) and ESRD (G5D), warfarin is commonly used, with reduced NOAC doses as an option. NOACs require careful monitoring of renal function, and hemodialysis can remove a significant portion of plasma dabigatran. Monitoring renal function is vital for CKD patients receiving NOACs. Some studies suggest NOACs may have a lower risk of cardiovascular events compared to warfarin, but conflicting data exist regarding bleeding risk. Individualized treatment decisions should consider the patient's renal function.

Antithrombotic Therapy in Chronic Kidney Disease

Clinical Department 3, Department of Nephrology, Fundeni, UMFCD, Department of Nephrology, Fundeni CI

Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Antithrombotic Therapy in Chronic Kidney Disease"}

Chronic kidney disease (CKD) affects over 10% of the global population and is more prevalent in the elderly, females, patients with diabetes or hypertension,...

Antithrombotic Therapy in Chronic Kidney Disease

Publié en ligne: 08 août 2023

Pages: 69 - 86

DOI: https://doi.org/10.2478/inmed-2023-0249

Mots clés
chronic kidney disease, sntithrombotic treatment, bleeding, cardiovascular events

© 2023 Camelia-Adriana Achim et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Antithrombotic Therapy in Chronic Kidney Disease

Publié en ligne: 08 août 2023

Pages: 69 - 86

DOI: https://doi.org/10.2478/inmed-2023-0249

Mots cléschronic kidney disease, sntithrombotic treatment, bleeding, cardiovascular events

© 2023 Camelia-Adriana Achim et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
chronic kidney disease, sntithrombotic treatment, bleeding, cardiovascular events