The following article features coverage from the National Kidney Foundation’s 2019 Spring Clinical Meetings. Click here to read more of Renal & Urology News’ conference coverage.

Apixaban is superior to warfarin in decreasing the incidence of stroke or systematic embolism and major bleeding in patients with atrial fibrillation (AF) and chronic kidney disease (CKD), according to the findings from a recent meta-analysis presented at the National Kidney Foundation’s 2019 Spring Clinical Meetings in Boston.

Rebaika Chopra, MD, of the Icahn School of Medicine at Mount Sinai, and colleagues analyzed data from 5 retrospective cohort studies that included a total of 10,438 patients with AF and stage 3 or 4 CKD or who were on hemodialysis. Of these, 2840 were on apixaban, a novel oral anticoagulant (NOAC), and 7598 were on warfarin.

Among patients with CKD stage 3 or 4, those treated with apixaban had a significant 36% and 50% decreased risk of stroke/venous thromboembolism (VTE) and major bleeding, respectively, the investigators reported in a poster presentation. Among patients on hemodialysis, apixaban was significant associated with a 59% decreased risk of major bleeding, but not significantly associated with a lower risk of stroke/VTE.


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The authors noted that NOACs are recommended over warfarin for anticoagulation in patients with AF, but AF clinical trials excluded patients with creatinine clearances below 25 mL/min/1.73 m2.

Read more of Renal & Urology News’ coverage of NKF’s 2019 Spring Clinical Meetings by visiting the conference page.

Reference

Chopra R, Kohli V, Jim B. The clinical efficacy and safety of apixaban versus warfarin for patients with atrial fibrillation and chronic renal disease: A meta-analysis. Poster presented at the National Kidney Foundation’s 2019 Spring Clinical Meetings in Boston, May 8-12. Poster 238.