Newer Anticoagulants Safer for CKD Patients

Meta-analysis reveals a lower risk of bleeding and arterial thromboembolism compared with conventional agents.
Meta-analysis reveals a lower risk of bleeding and arterial thromboembolism compared with conventional agents.

Newer oral anticoagulants (NOACs) are associated with lower bleeding risk compared with conventional medications in patients with chronic kidney disease (CKD), researchers reported at the American Society of Hematology annual meeting in Orlando, Fla.

“Our study showed that newer oral anticoagulants posed significantly less bleeding risk compared to conventional treatment in patients with mild renal insufficiency and appeared to be more efficacious in preventing arterial thrombosis in patients with mild to moderate renal insufficiency," lead investigator Srinath Sundararajan, MD, of the University of Arizona in Tucson, told Renal & Urology News. "Furthermore, the rates of venous thromboembolism with NOACs was comparable to conventional treatment, if not better,”.

Dr. Sundararajan and colleagues performed a meta-analysis of 16 randomized controlled trials that included 48,403 patients with mild to moderate renal insufficiency. Rivoroxaban, apixaban, edoxaban, and dabigatran were the newer oral anticoagulants tested in these trials.

Patients with mild renal insufficiency who received the newer agents had a significant 19% decreased bleeding risk and 32% decreased risk of arterial thromboembolism compared with those treated with conventional medications. Patients with moderate renal insufficiency treated with the newer agents had a significant 26% decreased risk of arterial thromboembolism and a trend toward a decreased bleeding risk. Among patients with mild and moderate renal insufficiency, Dr. Sundararajan's team observed a trend toward a decreased risk of venous thromboembolism in patients treated with the newer agents versus those treated with conventional medications. 

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