6533b7d1fe1ef96bd125cee6

RESEARCH PRODUCT

Atrial fibrillation and chronic kidney disease: focus on rivaroxaban

Vivencio BarriosJosé Luis Górriz

subject

medicine.medical_specialtyVitamin Kmedicine.drug_classRenal functionurologic and male genital diseasesNephropathyRivaroxabanInternal medicineAtrial FibrillationmedicineHumansRenal Insufficiency ChronicStrokeAgedRivaroxabanbusiness.industryHealth PolicyWarfarinAnticoagulantsAtrial fibrillationVitamin K antagonistmedicine.diseaseStrokeCardiologyWarfarinbusinessFactor Xa Inhibitorsmedicine.drugKidney disease

description

Renal insufficiency increases the risk of stroke and bleeding in atrial fibrillation patients. Although vitamin K antagonists reduce the risk of stroke in patients with moderate renal dysfunction, this observation is less clear in patients with renal impairment. Moreover, the risk of bleeding with vitamin K antagonists increases as renal function worsens. Maintaining international normalized ratio values within therapeutic targets is more difficult in patients with renal dysfunction, and those agents may cause warfarin-related nephropathy and vascular calcification. Rivaroxaban is the only nonvitamin K oral anticoagulant with a dose specifically tested in patients with moderate renal insufficiency. Rivaroxaban is effective for the prevention of stroke in atrial fibrillation patients with moderate renal dysfunction, with a lower risk of intracranial and fatal bleeding.

https://doi.org/10.2217/cer.15.44