Interv Akut Kardiol. 2019;18(3):134-136 | DOI: 10.36290/kar.2019.034

The issue of anticoagulation from a nephrologist’s perspective

Jan Vachek^1,2, Adéla Maříková², Vladimír Tesař¹

¹ Klinika nefrologie 1. LF UK a VFN v Praze

² Interní oddělení s hemodialyzační jednotkou, Klatovská nemocnice, a. s., Klatovy

The introduction of novel or direct oral anticoagulants (NOAC or DOAC) into the practice represented a major progress in anticoagulant therapy. It is not only with regard to the different elimination rates of individual anticoagulants by the kidneys that this drug class has been the subject of interest of nephrologists. However, the relationship of the kidneys and anticoagulants cannot be limited to the issue of the effect of renal dysfunction on drug elimination: it turns out that even anticoagulants can directly or indirectly affect renal function. An increased awareness of long-term (not only renal) complications of warfarin treatment has resulted from both the introduction of alternatives (NOAC) and the progress in the knowledge of vitamin K physiology. Kidney injury has also been observed in some patients treated with NOAC; therefore, the name of this nosological entity has been updated – instead of being called warfarin-related nephropathy (WRN), it is currently referred to as anticoagulant-related nephropathy. The aim of the article is to provide a comprehensive review of the relationship of anticoagulants and renal function as well as to compare available anticoagulants in terms of possible kidney injury.

Keywords: warfarin, novel oral anticoagulants (NOAC), vitamin K antagonists (VKA), warfarin-related nephropathy (WRN), glomerularfiltration rate (GFR), calcification

Published: November 1, 2019  Show citation