To access this material please log in or register

Register Authorize

Anticoagulation therapy in patients with atrial fibrillation and chronic kidney disease

Tatarsky B. A.1, Arutyunov G. P.2
1 – Federal State Budgetary Institution, “North-West Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St. Petersburg 97341
2 – State Budgetary Educational Institution of Higher Professional Education, “N. I. Pirogov Russian National Research Medical University” of the RF Ministry of Health Care, Ostrovityanova 1, Moscow 117997

Keywords: anticoagulant therapy, atrial fibrillation, chronic kidney disease

DOI: 10.18087/rhj.2016.1.2146

At present time, a connection of impaired kidney function with atrial fibrillation (AF) is well established. Presence of AF and chronic kidney disease increases the risk of stroke and systemic thromboses. This review focuses on discussion of safety and efficacy of antithrombotic therapy with direct oral anticoagulants in patients with AF and renal insufficiency.
  1. Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010 Oct;31 (19):2369–429.
  2. Hart RG, Eikelboom JW, Ingram AJ, Herzog CA. Anticoagulants in atrial fibrillation patients with chronic kidney disease. Nat Rev Nephrol. 2012 Oct;8 (10):569–78.
  3. Harder S. Renal profiles of anticoagulants. J Clin Pharmacol. 2012;52 (7):964–75.
  4. Piccini JP, Stevens SR, Chang Y, Singer DE, Lokhnygina Y, Go AS et al. Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R2CHADS2 index in the ROCKET AF and ATRIA study cohorts. Circulation. 2013 Jan 15;127 (2):224–32.
  5. Poulsen BK, Grove EL, Husted SE. New oral anticoagulants: a review of the literature with particular emphasis on patients with impaired renal function. Drugs. 2012 Sep 10;72 (13):1739–53.
  6. Olesen JB, Lip GY, Kamper AL, Hommel K, Kober L, Lane DA et al. Stroke and bleeding in atrial fibrillation with chronic kidney disease. N Engl J Med. 2012 Aug 16;367 (7):625–35.
  7. Roldán V, Marín F, Manzano-Fernandez S, Fernández H, Gallego P, Valdés M et al. Does chronic kidney disease improve the predictive value of the CHADS2 and CHA2DS2‑VASc stroke stratification risk scores for atrial fibrillation? Thromb Haemost. 2013 May;109 (5):956–60.
  8. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009 Sep 17;361 (12):1139–51.
  9. Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011 Sep 8;365 (10):883–91.
  10. Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011 Sep 15;365 (11):981–92.
  11. Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013 Nov 28;369 (22):2093–104.
  12. Lip GY, Larsen ТB, Skjoth F, Rasmussen LH. Indirect comparisons of new oral anticoagulant drugs for efficacy and safety when used for stroke prevention in atrial fibrillation. J Am Coll Cardiol. 2012 Aug 21;60 (8):738–46.
  13. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009 Aug 18;151 (4):W65–94.
  14. Chan NC, Paikin JS, Hirsh J, Lauw MN, Eikelboom JW, Ginsberg JS. New oral anticoagulants for stroke prevention in atrial fibrillation: impact of study design, double counting and unexpected fin­dings on interpretation of study results and conclusions. Thromb Haemost. 2014 May 5;111 (5):798–807.
  15. Stangier J, Rathgen K, Stahle H, Mazur D. Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. Clin Pharmacokinet. 2010 Apr;49 (4):259–68.
  16. Kubitza D, Mueck W, Stampfuss J, Becka M. Clinical pharmacokinetic and pharmacodynamic profile of rivaroxaban. Clin Pharmacokinet. 2014 Jan;53 (1):1–16.
  17. Мухин Н. А. Нефрология. Национальное руководство. – М.: «ГЭОТАР-Медиа», 2009. – 720с.
  18. Моисеев В. С., Мухин Н. А., Кобалава Ж. Д., Виллевальде С. В., Ефремовцева М. А., Козловская Л. В. и др. Основные положения проекта рекомендаций Всероссийского научного общества кардиологов и научного общества нефрологов России по оценке функционального состояния почек у больных сердечно-сосудистыми заболеваниями или с повышенным риском их развития. Кардиоваскулярная терапия и профилактика. 2008;7 (4):8–20.
  19. National Kidney Foundation. K / DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002 Feb;39 (2 Suppl 1):S1–266.
  20. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16 (1):31–41.
  21. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999 Mar 16;130 (6):461–70.
  22. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009 May 5;150 (9):604–12.
  23. Chronic Kidney Disease: National Clinical Guideline for Early Identification and Management in Adults in Primary and Secondary Care. London: Royal College of Physicians, 2008 ISBN-13: 978‑1‑86016‑340‑1
  24. Nyman HA, Dowling TC, Hudson JQ, Peter WL, Joy MS, Nolin TD. Comparative evaluation of the Cockcroft-Gault equation and the Modification of Diet in Renal Disease (MDRD) study equation for drug dosing: an opinion of the Nephrology Practice and Research Network of the American College of Clinical Pharmacy. Pharmacotherapy. 2011 Nov;31 (11):1130–44.
  25. Helou R. Should we continue to use the Cockcroft-Gault formula? Nephron Clin Pract. 2010;116 (3):172–85.
  26. Spruill WJ, Wade WE, Cobb HH. Comparison of estimated glome­rular filtration rate with estimated creatinine clearance in the dosing of drugs requiring adjustments in elderly patients with declining renal function. Am J Geriatr Pharmacother. 2008 Aug;6 (3):153–60.
  27. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1‑year risk of major bleed in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010 Nov;138 (5):1093–100.
  28. Nakagawa K, Hirai T, Takashima S, Fukuda N, Ohara K, Sasahara E et al. Chronic kidney disease and CHADS2 score independently predict cardiovascular events and mortality in patients with nonvalvular atrial fibrillation. Am J Cardiol. 2011 Mar 15;107 (6):912–6.
  29. Watanabe H, Watanabe T, Sasaki S, Nagai K, Roden DM, Aizawa Y. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009 Oct;158 (4):629–36.
  30. Hart RG, Pearce LA, Asinger RW, Herzog CA. Warfarin in atrial fibrillation patients with moderate chronic kidney disease. Clin J Am Soc Nephrol. 2011 Nov;6 (11):2599–604.
  31. Eikelboom JW, Connolly SJ, Gao P, Paolasso E, De Caterina R, Husted S et al. Stroke risk and efficacy of apixaban in atrial fibrillation patients with moderate chronic kidney disease. J Stroke Cerebrovasc Dis. 2012 Aug;21 (6):429–35.
  32. Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S et al. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011 Mar 3;364 (9):806–17.
  33. Limdi NA, Beasley TM, Baird MF, Goldstein JA, McGwin G, Arnett DK et al. Kidney function influences warfarin responsiveness and hemorrhagic complications. J Am Soc Nephrol. 2009 Apr;20 (4):912–21.
  34. Camm J, Savelieva I. «R» for «renal» and for «risk»: refining risk stratification forstroke in atrial fibrillation. Circulation. 2013 Jan 15;127 (2):169–71.
  35. Lega JC, Bertoletti L, Gremillet C, Boissier C, Mismetti P, Laporte S. Consistency of safety profile of new oral anticoagulants in patients with renal failure. J Thromb Haemost. 2014;12 (3):337–43.
  36. Sardar P, Chatterjee S, Herzog E, Nairooz R, Mukherjee D, Halperin JL. Novel oral anticoagulants in patients with renal insufficiency: a meta-analysis of randomized trials. Can J Cardiol. 2014 Aug;30 (8):888–97.
  37. Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013 May;15 (5):625–51.
  38. Deitelzweig S. Practical considerations in the use of novel oral anticoagulants for stroke prevention in nonvalvular atrial fibrillation. Cardiovasc Ther. 2014 Apr;32 (2):74–81.
  39. Kovacs RJ, Flaker GC, Saxonhouse SJ, Doherty JU, Birtcher KK, Cuker A et al. Practical Management of Anticoagulation in Patients With Atrial Fibrillation. J Am Coll Cardiol. 2015 Apr 7;65 (13):1340–60.
  40. Skanes AC, Healey JS, Cairns JA, Dorian P, Gillis AM, McMurty MS et al. Focused 2012 update of the Canadian Cardiovascular Society atrial fibrillation guidelines: recommendations for stroke prevention and rate / rhythm control. Can J Cardiol. 2012 Mar-Apr;28 (2):125–36.
  41. Fang MC, Go AS, Chang Y, Borowsky LH, Pomernacki NK, Udaltsova N, Singer DE. A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011 Jul 19;58 (4):395–401.
Tatarsky B. A., Arutyunov G. P. Anticoagulation therapy in patients with atrial fibrillation and chronic kidney disease. Russian Heart Journal. 2016;15 (1):40–49

To access this material please log in or register

Register Authorize
Ru En