SynthesisJournal of nephrology2022
A systematic review of the efficacy and safety of anticoagulants in advanced chronic kidney disease.
Synthesis in Journal of nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses 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
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Anticoagulation approaches in hemodialysis: a systematic review of efficacy, safety, and literature gap.International urology and nephrology · 2026Pooled it
- 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2026Guideline
- Efficacy and safety of novel anticoagulant therapies in patients with chronic kidney disease-a systematic review and meta-analysis.Journal of nephrology · 2025Pooled it
- Efficacy and safety of oral anticoagulants in the treatment of chronic kidney disease with atrial fibrillation or venous thromboembolism: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- What to do with key cardiovascular drugs when kidney function worsens?Clinical kidney journal · 2026Review
- Exploring prognostic factors on vascular outcomes among maintenance dialysis patients and establishing a prognosis prediction model using machine learning methods.BMC medical informatics and decision making · 2025Article
- Safety Profile of Warfarin and Apixaban for Deep Vein Thrombosis in Patients With Chronic Kidney Disease.Cureus · 2025Article
- Efficacy and safety of antithrombotics in patients with atrial fibrillation undergoing hemodialysis: a nationwide cohort study in Korea.Journal of nephrology · 2025Article
- Management of anticoagulation in patients with atrial fibrillation and renal dysfunction: A systematic review.World journal of experimental medicine · 2025Article
- Anticoagulation in Patients with End-Stage Renal Disease: A Critical Review.Healthcare (Basel, Switzerland) · 2025Review
- Unveiling the role of sex in the metabolism of indoxyl sulfate and apixaban.Scientific reports · 2025Article
- Facilitating active participation in anticoagulant decisions in advanced kidney disease: co-production of a question prompt list.BMC nephrology · 2025Article
- Article
- Anticoagulation control for nonvalvular atrial fibrillation in a tertiary academic centre in Johannesburg.Thrombosis journal · 2024Article
- Monitoring anti-factor Xa activity in patients with chronic thromboembolic pulmonary hypertension treated with factor Xa inhibitors.Scientific reports · 2024Article
- Article
- Apixaban Use in Patients with Kidney Impairment: A Review of Pharmacokinetic, Interventional, and Observational Study Data.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024Review
- Management of patients with heart failure and chronic kidney disease.Heart failure reviews · 2024Review
- Evaluation of Apixaban Use in Patients With Advanced Kidney Disease.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2024Article
- Anemia of Chronic Kidney Disease-A Narrative Review of Its Pathophysiology, Diagnosis, and Management.Biomedicines · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPatients with chronic kidney disease (CKD) have an increased risk of venous thromboembolism (VTE) and atrial fibrillation (AF). Anticoagulants have not been studied in randomised controlled trials with CrCl < 30 ml/min. The objective of this review was to identify the impact of different anticoagulant strategies in patients with advanced CKD including dialysis.
methodsWe conducted a systematic review of randomized controlled trials and cohort studies, searching electronic databases from 1946 to 2022. Studies that evaluated both thrombotic and bleeding outcomes with anticoagulant use in CrCl < 50 ml/min were included.
resultsOur initial search yielded 14,503 papers with 53 suitable for inclusion. RCTs comparing direct oral anticoagulants (DOACs) versus warfarin for patients with VTE and CrCl 30-50 ml/min found no difference in recurrent VTE events (RR 0.68(95% CI 0.42-1.11)) with reduced bleeding (RR 0.65 (95% CI 0.45-0.94)). Observational data in haemodialysis suggest lower risk of recurrent VTE and major bleeding with apixaban versus warfarin. Very few studies examining outcomes were available for therapeutic and prophylactic dose low molecular weight heparin for CrCl < 30 ml/min. Findings for patients with AF on dialysis were that warfarin or DOACs had a similar or higher risk of stroke compared to no anticoagulation. For patients with AF and CrCl < 30 ml/min not on dialysis, anticoagulation should be considered on an individual basis, with limited studies suggesting DOACs may have a preferable safety profile.
conclusionFurther studies are still required, some ongoing, in patients with advanced CKD (CrCl < 30 ml/min) to identify the safest and most effective treatment options for VTE and AF.
Indexed as
Identifiers
What OpenQuestion holds
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.