DOAC use reduces risk of CKD progression in patients with AF compared with VKA use

Written by Jacinthlyn Sylvia Published On 2023-02-24T20:00:54+05:30 | Updated On 24 Feb 2023 2:30 PM GMT

A recent study by Marco Trevisan and team found that Direct oral anticoagulant (DOAC) use is associated with a lower risk of chronic kidney disease (CKD) progression, acute kidney injury (AKI), and major bleeding compared to vitamin K antagonists (VKA) use in patients with nonvalvular atrial fibrillation (AF), with no significant difference in the risk of death or the composite of stroke and systemic embolism. The findings were published in American Journal of Kidney Diseases.

Direct oral anticoagulants have become the preferred choice over vitamin K antagonists for stroke prevention in patients with nonvalvular AF due to their lower risk of bleeding complications. This study aimed to investigate the impact of DOACs and VKAs on kidney outcomes in patients with nonvalvular AF.

The retrospective cohort study involved 32,699 Swedish patients with nonvalvular AF between 2011-2018. Patients were initiated on either DOAC or VKA treatment, and the primary outcomes were CKD progression and AKI. The secondary outcomes were death, major bleeding, and the composite of stroke and systemic embolism. Propensity score weighted Cox regression was used to balance 50 baseline confounders.

The study found that DOAC use was associated with a lower risk of CKD progression, AKI, and major bleeding compared to VKA use. The adjusted hazard ratios (HRs) for DOAC versus VKA were 0.87 for CKD progression and 0.88 for AKI. However, there was no significant difference in the risk of death or the composite of stroke and systemic embolism between the two groups. The results were consistent across subgroups of age, sex, and baseline eGFR, and when patients were at high risk for thromboembolic events.

Reference:

Trevisan, M., Hjemdahl, P., Clase, C. M., de Jong, Y., Evans, M., Bellocco, R., Fu, E. L., & Carrero, J. J. (2023). Cardiorenal Outcomes Among Patients With Atrial Fibrillation Treated With Oral Anticoagulants. In American Journal of Kidney Diseases (Vol. 81, Issue 3, pp. 307-317.e1). Elsevier BV. https://doi.org/10.1053/j.ajkd.2022.07.017

Source : American Journal of Kidney Diseases

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in