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Updated: May 9, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Overanticoagulation is associated with renal function decline.

Jan Cornelis van Blijderveen¹, Katia M Verhamme, Robert Zietse

¹Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Journal of Nephrology

|July 12, 2013

Summary

Overanticoagulation, defined as an international normalized ratio (INR) >6.0, is linked to impaired kidney function in patients taking warfarin. This study highlights the renal risks associated with excessive anticoagulation therapy.

Related Experiment Videos

Last Updated: May 9, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Area of Science:

Nephrology
Pharmacology
Geriatrics

Background:

Emerging evidence suggests that excessive anticoagulation, specifically with warfarin, may negatively impact kidney function.
Glomerular hemorrhage due to overanticoagulation can lead to renal tubular obstruction.

Purpose of the Study:

To investigate the association between overanticoagulation events and the decline in renal function.
To quantify the impact of elevated international normalized ratio (INR) levels on estimated glomerular filtration rate (eGFR) in older adults.

Main Methods:

Utilized data from the prospective, population-based Rotterdam Study, including 2,802 participants aged 55 years and older.
Employed linear regression to analyze the relationship between cumulative instances of overanticoagulation (INR >6.0) and changes in eGFR over time.
Adjusted for potential confounders such as age, sex, baseline renal function, heart failure, and the indication for vitamin K antagonist (VKA) therapy.

Main Results:

A statistically significant association was found between overanticoagulation events (INR >6.0) and a decline in renal function.
Each annual event of overanticoagulation was associated with a decrease of -0.180 ml/min per 1.73 m(2) in eGFR, after adjusting for covariates (p = 0.030).

Conclusions:

Overanticoagulation (INR >6.0) is demonstrably associated with a decline in renal function among patients on warfarin therapy.
Further research is warranted to explore the causal relationship between varying degrees of overanticoagulation and renal function, including transient effects and associations with newer oral anticoagulants.