THERAPEUTIC CLASS

Anticoagulation in CKD and ESRD

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In this review we discuss the evolving literature of anticoagulation in the context of the nephrology patient. Whereas CKDrnpatients with atrial fibrillation, should be anticoagulated, the benefit of anticoagulation for those on dialysis remains controversialrndue to an increased risk of bleeding. The availability of direct oral anticoagulants offers new options for thosernwith CKD. Until studies are available in stage 4 and 5/dialysis, this class of medication should be used with caution in thisrnpopulation. For anticoagulated patients requiring interventional procedures, a risk-based approach should be employed torndetermine those who will benefit from bridging anticoagulation. Either unfractionated heparin or low molecular weightrnheparin are adequate choices for bridging anticoagulation. Unfractionated heparin and renally dosed low molecular weightrnheparin can be safely used in non-end stage CKD patients with an acute coronary syndrome. Similarly, the use of unfractionatedrnheparin and low molecular weight heparin are comparable for thromboembolic prophylaxis in CKD/dialysis andrnextracorporeal circuit anticoagulation of the dialysis circuit

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: .,

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Language

English

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Classification

NONE

Content Type

Therapeutic Class

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Subject(s)

Fibrion
Cardiovascular & Hematopoietic System

Specific Detail Info

Journal of Nephrology 2019

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