PMID- 28929298
OWN - NLM
STAT- MEDLINE
DCOM- 20180320
LR  - 20181113
IS  - 1970-9366 (Electronic)
IS  - 1828-0447 (Linking)
VI  - 12
IP  - 8
DP  - 2017 Dec
TI  - Chronic kidney disease and anticoagulation: from vitamin K antagonists and 
      heparins to direct oral anticoagulant agents.
PG  - 1101-1108
LID - 10.1007/s11739-017-1753-2 [doi]
AB  - Anticoagulation in patients with impaired kidney function can be challenging 
      since drugs' pharmacokinetics and bioavailability are altered in this setting. 
      Patients with chronic kidney disease (CKD) treated with conventional 
      anticoagulant agents [vitamin K antagonist (VKA), low-molecular weight heparin 
      (LMWH) or unfractionated heparin (UFH)] are at high risk of bleeding events (both 
      non-major and major clinically relevant bleeding). While anticoagulation reduces 
      the risk of thromboembolic events, the co-existing bleeding risk and the fact 
      that the most commonly used anticoagulation agents are eliminated via the kidneys 
      pose additional challenges. More recently, two classes of direct oral 
      anticoagulant agents (DOACs) have been investigated for the prevention and 
      management of venous thromboembolic events: the direct factor Xa inhibitors 
      rivaroxaban, apixaban and edoxaban, and the direct thrombin inhibitor dabigatran. 
      In this review, we discuss the complex challenges and the practical 
      considerations associated with the management of anticoagulation treatment in 
      patients with CKD, with a special focus on DOACs.
FAU - Sciascia, Savino
AU  - Sciascia S
AD  - Center of Research of Immunopathology and Rare Diseases-Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, 
      Department of Clinical and Biological Sciences, University of Turin, Piazza del 
      Donatore di Sangue 3, 10154, Turin, Italy. savino.sciascia@unito.it.
AD  - Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. 
      Giovanni Bosco Hospital, University of Turin, Turin, Italy. 
      savino.sciascia@unito.it.
FAU - Radin, Massimo
AU  - Radin M
AD  - Center of Research of Immunopathology and Rare Diseases-Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, 
      Department of Clinical and Biological Sciences, University of Turin, Piazza del 
      Donatore di Sangue 3, 10154, Turin, Italy.
FAU - Schreiber, Karen
AU  - Schreiber K
AD  - Centre for Thrombosis and Haemostasis, St. Thomas' Hospital, London, UK.
AD  - Department of Rheumatology, Copenhagen University Hospital at Rigshospitalet, 
      Copenhagen, Denmark.
FAU - Fenoglio, Roberta
AU  - Fenoglio R
AD  - Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. 
      Giovanni Bosco Hospital, University of Turin, Turin, Italy.
FAU - Baldovino, Simone
AU  - Baldovino S
AD  - Center of Research of Immunopathology and Rare Diseases-Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, 
      Department of Clinical and Biological Sciences, University of Turin, Piazza del 
      Donatore di Sangue 3, 10154, Turin, Italy.
AD  - Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. 
      Giovanni Bosco Hospital, University of Turin, Turin, Italy.
FAU - Roccatello, Dario
AU  - Roccatello D
AD  - Center of Research of Immunopathology and Rare Diseases-Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, 
      Department of Clinical and Biological Sciences, University of Turin, Piazza del 
      Donatore di Sangue 3, 10154, Turin, Italy.
AD  - Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. 
      Giovanni Bosco Hospital, University of Turin, Turin, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170919
PL  - Italy
TA  - Intern Emerg Med
JT  - Internal and emergency medicine
JID - 101263418
RN  - 0 (Anticoagulants)
RN  - 0 (Pyrazoles)
RN  - 0 (Pyridones)
RN  - 12001-79-5 (Vitamin K)
RN  - 3Z9Y7UWC1J (apixaban)
RN  - 9005-49-6 (Heparin)
RN  - 9NDF7JZ4M3 (Rivaroxaban)
RN  - I0VM4M70GC (Dabigatran)
SB  - IM
MH  - Administration, Oral
MH  - Anticoagulants/*pharmacokinetics/pharmacology/therapeutic use
MH  - Dabigatran/pharmacokinetics/pharmacology/therapeutic use
MH  - Hemorrhage/prevention & control
MH  - Heparin/*pharmacology/therapeutic use
MH  - Humans
MH  - Pyrazoles/pharmacokinetics/pharmacology/therapeutic use
MH  - Pyridones/pharmacokinetics/pharmacology/therapeutic use
MH  - Renal Insufficiency, Chronic/*drug therapy
MH  - Rivaroxaban/pharmacokinetics/pharmacology/therapeutic use
MH  - Thrombosis/prevention & control
MH  - Vitamin K/*antagonists & inhibitors/pharmacology/therapeutic use
OTO - NOTNLM
OT  - Anticoagulation
OT  - Apixaban
OT  - Chronic kidney disease
OT  - Dabigatran etexilate
OT  - Direct anticoagulant agents
OT  - Factor Xa inhibitor
OT  - Heparins
OT  - Rivaroxaban
OT  - Thrombin inhibitor
OT  - Thrombosis
EDAT- 2017/09/21 06:00
MHDA- 2018/03/21 06:00
CRDT- 2017/09/21 06:00
PHST- 2017/06/28 00:00 [received]
PHST- 2017/09/11 00:00 [accepted]
PHST- 2017/09/21 06:00 [pubmed]
PHST- 2018/03/21 06:00 [medline]
PHST- 2017/09/21 06:00 [entrez]
AID - 10.1007/s11739-017-1753-2 [pii]
AID - 10.1007/s11739-017-1753-2 [doi]
PST - ppublish
SO  - Intern Emerg Med. 2017 Dec;12(8):1101-1108. doi: 10.1007/s11739-017-1753-2. Epub 
      2017 Sep 19.