Evidence map›Paper›PMID 40692319›Full record

ArticleThe Permanente journal2025

Comparison of Apixaban With Warfarin in Patients on Dialysis Within an Integrated Health Care System.

Tariq Shaheed, Douglas Stram, Aida Shirazi, Sumie Iwasaki, Cynthia Davila, Sijie Zheng

Abstract readComparative Study
In one paragraph

Article in The Permanente journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Tariq ShaheedThe Permanente Medical Group, Oakland, CA, USA.ORCID 0000-0001-9407-2862
Douglas StramDivision of Research, Kaiser Permanente, Pleasanton, CA, USA.
Aida ShiraziDepartment of Nephrology, Kaiser San Francisco Hospital, San Francisco, CA, USA.
Sumie IwasakiThe Permanente Medical Group, Oakland, CA, USA.
Cynthia DavilaDepartment of Nephrology, Kaiser San Francisco Hospital, San Francisco, CA, USA.
Sijie ZhengThe Permanente Medical Group, Oakland, CA, USA.ORCID 0009-0000-8792-0245

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe risk and benefit for patients on dialysis receiving anticoagulation (AC) therapy have not been clearly established. This study aimed to compare the rates of clinically significant thrombotic and bleeding events in patients on dialysis.

methodsThis is a retrospective cohort study conducted using Kaiser Permanente Northern California's electronic medical record database from 2013 to 2021. Patients over 18 years old on dialysis who were prescribed warfarin or apixaban were included. Patients with mechanical valves were excluded. The outcomes were analyzed using Mann-Whitney tests for continuous variables, χ

resultsIn the study period, 9832 patients were not on AC, and 2088 were taking apixaban or warfarin. The baseline demographics (age, Charlson Comorbidity Index, and sex) were comparable between apixaban and warfarin groups. Among the patients on anticoagulants, 181 were taking apixaban, while 1907 were taking only warfarin. The outcomes 1-3 years within the study period showed that the rates of clinically significant bleeding and thrombosis were comparable in both groups, with the exception of the rate of dialysis access thrombosis being lower in the apixaban group (7% vs 17%,

conclusionIn this diverse cohort, apixaban and warfarin showed no clinically significant differences in bleeding rates and lower rate of access thrombosis with apixaban. This study adds to the growing data of AC in the population with end-stage kidney disease, highlighting the need to enroll patients in an adequately powered randomized controlled trial to inform future practice.

Indexed as

AnticoagulantsFactor Xa InhibitorsPyrazolesPyridonesRenal DialysisThrombosisWarfarinAgedAged, 80 and overCaliforniaDelivery of Health Care, IntegratedFemaleHemorrhageHumansMaleMiddle AgedAnticoagulantsapixabanFactor Xa InhibitorsPyrazolesPyridonesWarfarinAtrial fibrillationBleedingCerebrovascular accidentDialysisDOACESKDShared decision makingVKA

Identifiers

PMID40692319
PMCPMC12485249

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.