Efficacy of Oral Anticoagulants in Chronic Kidney Disease and Hemodialysis Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis

Division

South Atlantic

Hospital

Orange Park Medical Center

Document Type

Manuscript

Publication Date

7-26-2024

Keywords

DOACs, direct oral anticoagulants, vitamin K antagonists, VKA, chronic kidney disease

Disciplines

Cardiovascular Diseases | Chemicals and Drugs | Female Urogenital Diseases and Pregnancy Complications | Internal Medicine | Male Urogenital Diseases | Medicine and Health Sciences

Abstract

INTRODUCTION: This meta-analysis seeks to evaluate the efficacy of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKA) in individuals with chronic kidney disease (CKD), end-stage renal disease (ESRD), and undergoing hemodialysis (HD) who also have atrial fibrillation (AF).

EVIDENCE ACQUISITION: A comprehensive search of MEDLINE, clinicaltrials.gov, EMBASE, and Cochrane Database for relevant studies reporting the usefulness of OAC therapy for CKD, ESRD, and HD patients with AF was conducted from its inception until 1

EVIDENCE SYNTHESIS: The meta-analysis included 33 studies with 178,956 patients. The analysis revealed that the DOACs, when compared to VKA, significantly lowered the risk of stroke or systemic embolism (HR: 0.81 [95% CI: 0.70, 0.93]; P=0.002; I

CONCLUSIONS: Our meta-analysis confirms that DOACs are effective for managing AF in patients with kidney disease, with potential clinical implications for AF and CKD management. Further research should explore DOACs' reno-protective effects.

Publisher or Conference

Minerva Cardiology and Angiology

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