Association of Mild to Moderate Chronic Kidney Disease With Venous Thromboembolism

Mahmoodi, Bakhtawar K.; Gansevoort, Ron T.; Næss, Inger Anne; Lutsey, Pamela L.; Brækkan, Sigrid Kufaas; Veeger, Nic J. G. M.; Brodin, Ellen; Meijer, Karina; Sang, Yingying; Matsushita, Kunihiro; Hallan, Stein; Hammerstrøm, Jens; Cannegieter, Suzanne C.; Astor, Brad C.; Coresh, Josef; Folsom, Aaron R.; Hansen, John Bjarne; Cushman, Mary

doi:10.1161/circulationaha.112.113944

Cited by 109 publications

(54 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, patients with cirrhosis are at risk of developing both acute and chronic kidney disease [83][84][85][86][87]. In the general population, chronic renal disease is associated with a high thrombotic risk, while in acute renal failure the bleeding risk prevails over that of thrombosis.…”

Section: Factors Tipping the Hemostatic Balance In Cirrhosismentioning

confidence: 99%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

View full text Add to dashboard Cite

a b s t r a c tPatients with cirrhosis present with hemostatic alterations secondary to reduced availability of procoagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.

show abstract

Section: Factors Tipping the Hemostatic Balance In Cirrhosismentioning

confidence: 99%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

View full text Add to dashboard Cite

show abstract

“…In particular, an association between reduced estimated glomerular filtration rate (eGFR) and an increased VTE risk was found [5,8], even in the non-CKD range of eGFR [8], although other studies confirmed this association for only severe eGFR reductions [7].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies suggested that chronic kidney diseases (CKD) may be associated with increased VTE risk in the general population, but conflicting results were reported [4][5][6][7][8]. In particular, an association between reduced estimated glomerular filtration rate (eGFR) and an increased VTE risk was found [5,8], even in the non-CKD range of eGFR [8], although other studies confirmed this association for only severe eGFR reductions [7].…”

Section: Introductionmentioning

confidence: 99%

Estimated Glomerular Filtration Rate Is an Easy Predictor of Venous Thromboembolism in Cancer Patients Undergoing Platinum-Based Chemotherapy

et al. 2014

View full text Add to dashboard Cite

Background. Reduced estimated glomerular filtration rate (eGFR) has been associated with increased venous thromboembolism (VTE) risk in the general population. VTE incidence significantly increases in cancer patients, especially those undergoing chemotherapy. Despite the evidence that a substantial number ofcancer patients have unrecognized renal impairment, as indicated by reduced eGFR in the presence of serum creatinine levels within the reference value, chemotherapy dosage is routinely adjusted for serum creatinine values. Among chemotherapies, platinum-based regimens are associated with the highest rates of VTE. A cohort study was designed to assess the value of pretreatment eGFR in the risk prediction of a first VTE episode in cancer outpatients without previous history of VTE who were scheduled for platinum-based chemotherapy. Methods. Serum creatinine and eGFR were evaluated before the start of standard platinum-based chemotherapy in a cohort of 322 consecutive patients with primary or

show abstract

“…9,10 CKD is increasing in prevalence and is associated with an increased risk of atrial fibrillation and venous thrombosis, both of which are indications for NOAC use. 11,12 In North America, these agents have been approved by the US Food and Drug Administration and Health Canada for use in patients with varying degrees of kidney dysfunction. However, these agencies have extrapolated the efficacy and safety data from the NOAC trials and approved dabigatran and rivaroxaban for use in patients with more severe CKD, despite the exclusion of such patients from the trials (Table 1).…”

mentioning

confidence: 99%

Comparisons between Novel Oral Anticoagulants and Vitamin K Antagonists in Patients with CKD

Harel¹,

Sholzberg

Shah³

et al. 2014

Journal of the American Society of Nephrology

101

View full text Add to dashboard Cite

Novel oral anticoagulants (NOACs) (rivaroxaban, dabigatran, apixaban) have been approved by international regulatory agencies to treat atrial fibrillation and venous thromboembolism in patients with kidney dysfunction. However, altered metabolism of these drugs in the setting of impaired kidney function may subject patients with CKD to alterations in their efficacy and a higher risk of bleeding. This article examined the efficacy and safety of the NOACs versus vitamin K antagonists (VKAs) for atrial fibrillation and venous thromboembolism in patients with CKD. A systematic review and meta-analyses of randomized controlled trials were conducted to estimate relative risk (RR) with 95% confidence interval (95% CIs) using a random-effects model. MEDLINE, Embase, and the Cochrane Library were searched to identify articles published up to March 2013. We selected published randomized controlled trials of NOACs compared with VKAs of at least 4 weeks' duration that enrolled patients with CKD (defined as creatinine clearance of 30-50 ml/min) and reported data on comparative efficacy and bleeding events. Eight randomized controlled trials were eligible. There was no significant difference in the primary efficacy outcomes of stroke and systemic thromboembolism (four trials, 9693 participants; RR, 0.64 [95% CI, 0.39 to 1.04]) and recurrent thromboembolism or thromboembolism-related death (four trials, 891 participants; RR, 0.97 [95% CI, 0.43 to 2.15]) with NOACs versus VKAs. The risk of major bleeding or the combined endpoint of major bleeding or clinically relevant nonmajor bleeding (primary safety outcome) (eight trials, 10,616 participants; RR 0.89 [95% CI, 0.68 to 1.16]) was similar between the groups. The use of NOACs in select patients with CKD demonstrates efficacy and safety similar to those with VKAs. Proactive postmarketing surveillance and further studies are pivotal to further define the rational use of these agents.

show abstract

Association of Mild to Moderate Chronic Kidney Disease With Venous Thromboembolism

Cited by 109 publications

References 39 publications

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Estimated Glomerular Filtration Rate Is an Easy Predictor of Venous Thromboembolism in Cancer Patients Undergoing Platinum-Based Chemotherapy

Comparisons between Novel Oral Anticoagulants and Vitamin K Antagonists in Patients with CKD

Contact Info

Product

Resources

About