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The following is a summary of “Efficacy and safety of novel anticoagulant therapies in patients with chronic kidney disease—a systematic review and meta-analysis,” published in the November 2024 issue of Nephrology by Martinez et al.
Chronic Kidney Disease (CKD) increases the risk of cardiovascular diseases, including atrial fibrillation, which often requires anticoagulant therapy.
Researchers conducted a retrospective study to compare the effectiveness and safety of direct oral anticoagulants and vitamin K antagonists in patients with CKD.
They conducted a systematic review registered in PROSPERO (CRD42023410192) following PRISMA guidelines. Randomized clinical trials and cohort studies comparing direct oral anticoagulants and vitamin K antagonists in patients with CKD were included. Major databases were searched, and studies met strict inclusion criteria. A meta-analysis was performed using random-effects models.
The results showed that 23 studies with 465,673 patients with CKD were included. Direct oral anticoagulants significantly reduced major bleeding events (Relative Risk [RR] = 0.62, 95% CI: 0.49–0.79, P < 0.01) and showed a non-significant trend toward reducing thromboembolic events (RR = 0.69, 95% CI: 0.43–1.14, P = 0.11). They also significantly reduced all-cause mortality (RR = 0.63, 95% CI: 0.43–0.91, P = 0.02).
They concluded that direct oral anticoagulants were a safer alternative to vitamin K antagonists in patients with CKD, reducing bleeding risks and improving survival. However, their effectiveness in preventing thromboembolic events remained uncertain, warranting further research.
Source:link.springer.com/article/10.1007/s40620-024-02130-3
