About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Nonvitamin K Anticoagulants Promise Better Kidney Protection to Warfarin

Font : A-A+

Highlights
  • Atrial fibrillation patients could be less prone to kidney damage with non-vitamin k anticoagulants
  • Decline in kidney function is very common among atrial fibrillation patients on blood thinners or anticoagulants over time
  • The reduced kidney function could lead to kidney failure, dialysis and potentially death

Nonvitamin K Anticoagulants Promise Better Kidney Protection to Warfarin

Non-vitamin K anticoagulants can be associated with lower kidney damage when compared to warfarin in atrial fibrillation patients, found a new study published in Journal of the American College journal.

Their study, published online today in the Journal of the American College of Cardiology, is the most recent in a series of studies seeking to determine the safety and efficacy of non-vitamin K antagonist oral anticoagulants versus the long-standard warfarin.

Advertisement


Patients with atrial fibrillation - a potent risk factor for stroke -- commonly take these medications.

"Kidney function decline in patients taking oral anticoagulant drugs is an important topic that has been overlooked in previous clinical trials," says lead author Xiaoxi Yao, Ph.D. "Even our past work at Mayo Clinic has been primarily focused on risks for stroke or bleeding."
Advertisement

However, she and the senior study author, Peter Noseworthy, M.D., a Mayo Clinic cardiologist, along with the rest of their team, felt that the issue was worth pursuing.

Renal function decline with non vitamin k antagonists anticoagulants

"Our study demonstrated that renal function decline is very common among atrial fibrillation patients on blood thinners," says Dr. Yao. "About 1 in 4 patients had significantly reduced kidney function within two years of being on any of these medications, and 1 in 7 patients had acute kidney injury."

The reduced kidney function could lead to kidney failure, dialysis and potentially death. Finding this, the researchers went a step further, trying to determine if the type of medication made a difference.

"In general, patients with atrial fibrillation taking blood-thinning medications tend to have declining kidney function over time," says Dr. Noseworthy. "However, our findings indicate that the non-vitamin K antagonist oral anticoagulants as a group are associated with less injury to kidneys than warfarin."

To come to these conclusions, the researchers studied the de-identified records of 9,769 patients from the OptumLabs Data Warehouse. These patients had atrial fibrillation and started taking oral anticoagulants -- apixaban, dabigatran, rivaroxaban or warfarin -- sometime between Oct. 1, 2010, and April 30, 2016.

The team looked at four indicators of kidney function: thirty percent decline (or more) in glomerular filtration rate (how well the kidneys filter waste), Doubled serum creatinine level (a waste product that should be filtered by the kidneys), Acute kidney injury, Kidney failure

They found that the cumulative risk of one of these four events occurring within two years of beginning the medication was 24.4 percent, 4 percent, 14.8 percent and 1.7 percent, respectively, proving that kidney function decline is common in these patients.

However, the researchers took it a step further and separated out the patients taking non-vitamin K antagonist oral anticoagulants from those taking warfarin.

"We found that non-vitamin K antagonist oral anticoagulants, as a group, were associated with reduced risk of adverse kidney outcomes," says Dr. Noseworthy.

"Patients with atrial fibrillation already face a high risk of kidney disease, perhaps because many such patients have risk factors, such as advanced age, diabetes, and hypertension," says Dr. Yao. "Many drugs these patients are taking rely on kidney function for drug elimination. Therefore, it is particularly important for these patients to choose a drug that minimizes the impact on kidneys. Since non-vitamin K antagonist oral anticoagulants have a different drug mechanism than warfarin, researchers have hypothesized that non-vitamin K antagonist oral anticoagulants may be related to better renal outcomes. Our study is among the first few studies confirming this hypothesis."

Their findings have important implications for medical practice, she says, and Dr. Noseworthy confirms.

"Just as I do with my own patients, I encourage conversations on these risks and benefits between patients and their providers," says Dr. Noseworthy.

"Each patient's situation is different, so each medication decision must be made based on the individual's lifestyle and diet, other illnesses and medications, out-of-pocket costs, and so forth."

Both he and Dr. Yao encourage health care providers to regularly follow up and monitor kidney function in their patients taking anticoagulants. They urge providers to make efforts to prevent or slow kidney function decline, as well as adjust drug dosage based on the change of kidney function. And, as with all medications, Dr. Noseworthy cautions patients to never stop or change any medication dosage without consulting with their healthcare providers.

Reference
  1. Xiaoxi Yao, Nilay D. Shah, Lindsey R. Sangaralingham, Bernard J. Gersh and Peter A. Noseworthy. Non-Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction, Journal of the American College of Cardiology (2017). DOI: 10.1016/j.jacc.2017.03.600


Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Advertisement
News Category
What's New on Medindia
Goji Berries May Protect Against Age-Related Vision Loss
Tapping — A Proven Self-Applied Stress Intervention
Black Pepper as Preventive Measure Against Omicron
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Urinary Stones In Children Vesico-Ureteric Reflux Causing UTI in Children Hydronephrosis / Antenatal Counseling Kidney Disease Kidney Kidney Health Stones in Urinary Tract Anticoagulants Deep Vein Thrombosis Renal Tubular Acidosis 

Recommended Reading
Common Side Effects of Anticoagulants / Blood Thinners
The main side effect of anticoagulants or blood thinners is bleeding. Others include reduced ......
Anticoagulants
Anticoagulants prevent the clotting of blood in our body. They are administered orally or via ......
Heart Attack
Heart attack is the death of the heart muscle due to loss of blood supply. Heart disease is the ......
Deep Vein Thrombosis
A blood clot (thrombus) in the deep venous system of the leg leads to deep vein thrombosis (DVT). DV...
Hydronephrosis / Antenatal Counseling
Currently most pregnant women undergo one or two ultrasound scans during their pregnancy....
Renal Tubular Acidosis
Renal tubular acidosis/RTA results in acid content of the blood being higher than normal and that of...
Stones in Urinary Tract
Ask people who have suffered from urinary stones and they will tell you how excruciating the pain ca...
Urinary Stones In Children
There is a wide misconception that only adults develop stones. On the contrary kidney stones are ver...
Vesico-Ureteric Reflux Causing UTI in Children
Bacterial infection of urinary bladder can cause pain and burning sensation while passing urine. Abn...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2022

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use
open close
CONSULT A DOCTOR
I have read and I do accept terms of use - Telemedicine

Advantage Medindia: FREE subscription for 'Personalised Health & Wellness website with consultation' (Value Rs.300/-)