Rivaroxaban e malattia renale cronica: evidenze dal presente e prospettive future

Luca Di Lullo; Claudio Ronco; Fulvio Floccari; Antonio De Pascalis; Vincenzo Barbera; Rodolfo Rivera; Antonio Bellasi

doi:10.33393/gcnd.2019.507

Authors

Luca Di Lullo UOC Nefrologia e Dialisi, Ospedale L. Parodi – Delfino, Colleferro, Italy
Claudio Ronco International Renal Research Institute, Ospedale S. Bortolo, Vicenza, Italy
Fulvio Floccari UOC Nefrologia e Dialisi, Ospedale “S. Paolo”, Civitavecchia, Italy
Antonio De Pascalis UOC Nefrologia e Dialisi, Ospedale “V. Fazzi”, Lecce, Italy
Vincenzo Barbera UOC Nefrologia e Dialisi, Ospedale L. Parodi – Delfino, Colleferro, Italy
Rodolfo Rivera Clinica Nefrologica, Ospedale “S.Gerardo”, Monza, Italy
Antonio Bellasi Department of Research, Innovation and Brand Reputation, ASST (Azienda Socio Sanitaria Territoriale) Papa Giovanni XXIII, Bergamo, Italy

DOI:

https://doi.org/10.33393/gcnd.2019.507

Keywords:

Atrial fibrillation, Chronic kidney disease, Warfarin, Direct oral anticoagulants, Rivaroxaban

Abstract

Cardiovascular diseases represent the main cause of comorbidly in chronic kidney disease (CKD) patients, with a 7% incidence in atrial fibrillation (AF) in end-stage renal disease (ESRD) patients. Until recently, prophylactic treatment of atrial fibrillation complications (such as thromboembolism) was mainly based on vitamin K antagonists (VKA) or heparin. In the last years, direct oral anticoagulants (DOACs) have been made available; however, their renal clearance limits their use on patients with severe renal impairment (eGFR <15 mL/min). Among DOACs, Rivaroxaban, a factor X-activated (Xa) inhibitor, shows good renal profile and it can be used in CKD patients up to stage 4 as well as in ESRD patients (at the moment only in North America and Canada). (Cardionephrology)