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Glomerular filtration rate in patients with atrial fibrillation on warfarin treatment: A subgroup analysis from the AURICULA registry in Sweden.

Jönsson, Karl LU ; Wieloch, Mattias LU ; Sterner, Gunnar LU ; Nyman, Ulf LU ; Elmståhl, Sölve LU ; Engström, Gunnar LU and Svensson, Peter LU (2011) In Thrombosis Research 128(4). p.341-345
Abstract
INTRODUCTION: Numerous associations between chronic kidney disease (CKD) and atrial fibrillation (AF) have been reported and patients with CKD on anticoagulation therapy have an increased risk of bleeding. Currently, new anticoagulant agents are emerging in clinical practice, some of which are excreted by the kidneys. The proportion of AF patients on anticoagulant treatment with reduced renal function is, however, unknown. MATERIALS AND METHODS: Using AURICULA, a Swedish registry for anticoagulation, estimated glomerular filtration rate (eGFR) was investigated in AF patients on warfarin treatment (n=2,603). The study group was compared with a healthy sample from the population (n=2,261). Two different creatinine prediction equations were... (More)
INTRODUCTION: Numerous associations between chronic kidney disease (CKD) and atrial fibrillation (AF) have been reported and patients with CKD on anticoagulation therapy have an increased risk of bleeding. Currently, new anticoagulant agents are emerging in clinical practice, some of which are excreted by the kidneys. The proportion of AF patients on anticoagulant treatment with reduced renal function is, however, unknown. MATERIALS AND METHODS: Using AURICULA, a Swedish registry for anticoagulation, estimated glomerular filtration rate (eGFR) was investigated in AF patients on warfarin treatment (n=2,603). The study group was compared with a healthy sample from the population (n=2,261). Two different creatinine prediction equations were used for calculating eGFR: the Lund-Malmö (LM) and MDRD Study equation. RESULTS: The fraction of AF patients with eGFR <30 and <45ml/min/1.73m(2) were 8.1% and 22.9% with the LM and 4.3% and 16.3% with the MDRD equation, respectively, and significantly higher than corresponding values in the reference population. GFR decreased with increasing age, where 11.4% and 5.6% of AF patients aged≥75years had eGFR <30ml/min/1.73m(2) according to the LM and MDRD equations, respectively. CONCLUSIONS: Severe renal impairment is common among AF patients on anticoagulant treatment with warfarin, especially at higher ages. Monitoring of renal function should be implemented in clinical practice for AF patients treated with new anticoagulants eliminated by the kidneys. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thrombosis Research
volume
128
issue
4
pages
341 - 345
publisher
Elsevier
external identifiers
  • wos:000295212200017
  • pmid:21620441
  • scopus:80054921468
  • pmid:21620441
ISSN
1879-2472
DOI
10.1016/j.thromres.2011.04.022
language
English
LU publication?
yes
id
0a43c07a-d594-4192-a673-b9b8d3b0445b (old id 2168593)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21620441?dopt=Abstract
date added to LUP
2016-04-04 08:25:31
date last changed
2022-03-15 08:13:34
@article{0a43c07a-d594-4192-a673-b9b8d3b0445b,
  abstract     = {{INTRODUCTION: Numerous associations between chronic kidney disease (CKD) and atrial fibrillation (AF) have been reported and patients with CKD on anticoagulation therapy have an increased risk of bleeding. Currently, new anticoagulant agents are emerging in clinical practice, some of which are excreted by the kidneys. The proportion of AF patients on anticoagulant treatment with reduced renal function is, however, unknown. MATERIALS AND METHODS: Using AURICULA, a Swedish registry for anticoagulation, estimated glomerular filtration rate (eGFR) was investigated in AF patients on warfarin treatment (n=2,603). The study group was compared with a healthy sample from the population (n=2,261). Two different creatinine prediction equations were used for calculating eGFR: the Lund-Malmö (LM) and MDRD Study equation. RESULTS: The fraction of AF patients with eGFR &lt;30 and &lt;45ml/min/1.73m(2) were 8.1% and 22.9% with the LM and 4.3% and 16.3% with the MDRD equation, respectively, and significantly higher than corresponding values in the reference population. GFR decreased with increasing age, where 11.4% and 5.6% of AF patients aged≥75years had eGFR &lt;30ml/min/1.73m(2) according to the LM and MDRD equations, respectively. CONCLUSIONS: Severe renal impairment is common among AF patients on anticoagulant treatment with warfarin, especially at higher ages. Monitoring of renal function should be implemented in clinical practice for AF patients treated with new anticoagulants eliminated by the kidneys.}},
  author       = {{Jönsson, Karl and Wieloch, Mattias and Sterner, Gunnar and Nyman, Ulf and Elmståhl, Sölve and Engström, Gunnar and Svensson, Peter}},
  issn         = {{1879-2472}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{341--345}},
  publisher    = {{Elsevier}},
  series       = {{Thrombosis Research}},
  title        = {{Glomerular filtration rate in patients with atrial fibrillation on warfarin treatment: A subgroup analysis from the AURICULA registry in Sweden.}},
  url          = {{http://dx.doi.org/10.1016/j.thromres.2011.04.022}},
  doi          = {{10.1016/j.thromres.2011.04.022}},
  volume       = {{128}},
  year         = {{2011}},
}