Direct oral anticoagulants for the treatment of pulmonary embolism in patients with renal impairment.

Pulmonary embolism (PE) is associated with adverse outcomes and substantial morbidity and mortality. Patients with PE often have renal impairment because of shared risk factors and close links between the renal and cardiovascular systems. Furthermore, patients with PE and renal impairment are at increased risk of recurrent thrombosis. Therefore, anticoagulation is crucial to treat the acute event, prevent recurrent venous thromboembolism (VTE), and optimize patient outcomes. However, when treated with an anticoagulant, patients with renal impairment also have an elevated risk of bleeding. Direct oral anticoagulants (DOACs) are the first-choice treatment for acute VTE in eligible patients. H…