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Renal function and venous thromboembolic diseases

N Janus1, I Mahé2, V Launay-Vacher1

  • 1Service ICAR, Pitié-Salpêtrière university hospital, 83, boulevard de l'Hôpital, 75013 Paris, France; Department of nephrology, Pitié-Salpêtrière hospital, 75013 Paris, France.

Journal Des Maladies Vasculaires
|December 29, 2016
PubMed

Insights

Patients with venous thromboembolism (VTE) often have chronic kidney disease (CKD). Managing anticoagulants in CKD patients requires dose adjustments to prevent bleeding risks, necessitating CKD screening in VTE patients.

Area of Science:

  • Nephrology
  • Hematology
  • Pharmacology

Background:

  • Venous thromboembolism (VTE) affects numerous patients, with a high comorbidity of chronic kidney disease (CKD).
  • CKD is independently associated with VTE and increases risks for cardiovascular events and fatal pulmonary embolism.
  • The pharmacokinetic profiles of anticoagulant medications are altered in patients with CKD.

Purpose of the Study:

  • To highlight the clinical challenge of managing anticoagulation in VTE patients with CKD.
  • To emphasize the pharmacokinetic alterations of anticoagulants in CKD and their implications.
  • To advocate for screening VTE patients for CKD and adjusting anticoagulant dosages.

Main Methods:

  • Literature review on VTE, CKD, and anticoagulation.
  • Analysis of pharmacokinetic changes of anticoagulants in renal impairment.
  • Clinical guideline review for anticoagulation in CKD.

Main Results:

  • CKD is prevalent in VTE patients and is a significant risk factor.
  • Altered drug metabolism in CKD can lead to anticoagulant overdosage and bleeding.
  • Current management strategies require careful consideration of renal function.

Conclusions:

  • Screening for CKD in patients with VTE is crucial.
  • Anticoagulant dosages must be adjusted based on renal function to mitigate bleeding risks.
  • Further research is needed to optimize anticoagulation strategies in CKD patients.

Keywords:
AnticoagulantsAnticoagulants agentsChronic kidney diseaseInsuffisance rénale chroniqueMaladie thrombo-embolique veineuseVenous thromboembolism

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