SynthesisJournal of the American Society of Nephrology : JASN2014
Comparisons between novel oral anticoagulants and vitamin K antagonists in patients with CKD.
Synthesis in Journal of the American Society of Nephrology : JASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 107 citations in OpenAlex.
- Renal function and non-vitamin K oral anticoagulants in comparison with warfarin on safety and efficacy outcomes in atrial fibrillation patients: a systemic review and meta-regression analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Pooled it
- Renal function in atrial fibrillation patients switched from warfarin to a direct oral anticoagulant.Journal of thrombosis and thrombolysis · 2016Trial
- Anticoagulation for Patients with Atrial Fibrillation Receiving Dialysis: A Pilot Randomized Controlled Trial.Journal of the American Society of Nephrology : JASN · 2025Article
- Efficacy and safety of anticoagulant for treatment and prophylaxis of VTE patients with renal insufficiency: a systemic review and meta-analysis.Thrombosis journal · 2024Review
- Pharmacokinetic relevance of glomerular hyperfiltration for drug dosing.Clinical kidney journal · 2023Review
- Reply to Letter to the Editor: 'Anticoagulation in Real-Life Patients with Atrial Fibrillation: Impact of Renal Disease'.Anatolian journal of cardiology · 2023Article
- The Safety of Direct Oral Anticoagulants Versus Warfarin Among Older Individuals With Acute Venous Thromboembolism and CKD: A Population-Based Cohort Study.Kidney medicine · 2022Article
- A treatment-specific marginal structural Cox model for the effect of treatment discontinuation.Pharmaceutical statistics · 2022Article
- Globular adiponectin inhibits osteoblastic differentiation of vascular smooth muscle cells through the PI3K/AKT and Wnt/β-catenin pathway.Journal of molecular histology · 2021Article
- Controversies: Stroke Prevention in Chronic Kidney Disease.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021Review
- Should We Continue Assessing Glomerular Filtration Rate with the Cockroft-Gault Formula in NOAC-Treated Patients? The Magnitude of the Problem.Journal of clinical medicine · 2020Article
- Anticoagulation in chronic kidney disease: from guidelines to clinical practice.Clinical cardiology · 2019Review
- Clinical Pharmacology of Oral Anticoagulants in Patients with Kidney Disease.Clinical journal of the American Society of Nephrology : CJASN · 2019Review
- Canadian Nephrologist Views Regarding Stroke and Systemic Embolism Prevention in Dialysis Patients With Nonvalvular Atrial Fibrillation: A Survey.Canadian journal of kidney health and disease · 2019Article
- Venous Thromboembolism: A Survey of Oral Anticoagulant Preferences in the Treatment of Challenging Patient Populations.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Article
- Dosing challenges with direct oral anticoagulants in the elderly: a retrospective analysis.Therapeutic advances in drug safety · 2018Article
- Estimated glomerular filtration ratio is a better index than creatinine clearance (Cockcroft-Gault) for predicting the prevalence of atrial fibrillation in the general Japanese population.Hypertension research : official journal of the Japanese Society of Hypertension · 2018Article
- Non-Vitamin K Oral Anticoagulants for Stroke Prevention in Special Populations with Atrial Fibrillation.Advances in therapy · 2017Review
- Assessment of Direct Oral Anticoagulant Prescribing and Monitoring Pre- and Post-Implementation of a Pharmacy Protocol at a Community Teaching Hospital.Hospital pharmacy · 2017Article
- Effectiveness and safety of reduced dose non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study.BMJ (Clinical research ed.) · 2017Observational
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
Novel oral anticoagulants (NOACs) (rivaroxaban, dabigatran, apixaban) have been approved by international regulatory agencies to treat atrial fibrillation and venous thromboembolism in patients with kidney dysfunction. However, altered metabolism of these drugs in the setting of impaired kidney function may subject patients with CKD to alterations in their efficacy and a higher risk of bleeding. This article examined the efficacy and safety of the NOACs versus vitamin K antagonists (VKAs) for atrial fibrillation and venous thromboembolism in patients with CKD. A systematic review and meta-analyses of randomized controlled trials were conducted to estimate relative risk (RR) with 95% confidence interval (95% CIs) using a random-effects model. MEDLINE, Embase, and the Cochrane Library were searched to identify articles published up to March 2013. We selected published randomized controlled trials of NOACs compared with VKAs of at least 4 weeks' duration that enrolled patients with CKD (defined as creatinine clearance of 30-50 ml/min) and reported data on comparative efficacy and bleeding events. Eight randomized controlled trials were eligible. There was no significant difference in the primary efficacy outcomes of stroke and systemic thromboembolism (four trials, 9693 participants; RR, 0.64 [95% CI, 0.39 to 1.04]) and recurrent thromboembolism or thromboembolism-related death (four trials, 891 participants; RR, 0.97 [95% CI, 0.43 to 2.15]) with NOACs versus VKAs. The risk of major bleeding or the combined endpoint of major bleeding or clinically relevant nonmajor bleeding (primary safety outcome) (eight trials, 10,616 participants; RR 0.89 [95% CI, 0.68 to 1.16]) was similar between the groups. The use of NOACs in select patients with CKD demonstrates efficacy and safety similar to those with VKAs. Proactive postmarketing surveillance and further studies are pivotal to further define the rational use of these agents.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.