Anticoagulation in patients with kidney disease: One size does not fit all

摘要

In the general population there is clear evidence for the role of anticoagulation for conditions such as atrial fibrillation and venous thromboembolism. For most of these patients, oral anticoagulants reduce the risk of thrombotic events, with a small acceptable increase in the risk of bleeding. However, patients with chronic kidney disease (CKD) have a higher risk of thromboembolism, and are also at increased risk of bleeding complications from anticoagulation. As such, extrapolating general population findings for efficacy and safety of oral anticoagulants to patients with CKD and kidney failure (KF) remains highly controversial.