Department of Vascular and Endovascular Surgery, Angiology and Phlebology Poznan University of Medical Sciences, Ponzon, Poland.
Curr Pharm Des. 2018;24(38):4505-4510. doi: 10.2174/1381612825666190130144051.
In daily practice, chemical substances called "direct oral anticoagulants" or DOACs are more convenient to administer when set beside vitamin K antagonists (VKA) due to improved pharmacologic properties, fewer drug interactions and rapid onset of action. The objective of this review was to assess whether DOACs are the alternative for VKA in subjects with mild-to-moderate chronic kidney disease (CKD). An analysis of current DOAC trials and studies was performed focusing on subjects with CKD. This review concludes that although DOACS are not recommended in the course of advanced chronic kidney disease (CrCl<30mL/min) or during dialysis, DOACS are a reasonable choice for individuals with mild to moderate CKD.
在日常实践中，与维生素 K 拮抗剂 (VKA) 相比，称为“直接口服抗凝剂”或 DOAC 的化学物质由于具有更好的药理特性、更少的药物相互作用和更快的作用起效时间，因此在给药时更为方便。本综述的目的是评估 DOAC 是否可替代轻中度慢性肾脏病 (CKD) 患者的 VKA。对目前针对 CKD 患者的 DOAC 试验和研究进行了分析。本综述得出结论，尽管 DOAC 不推荐用于晚期慢性肾脏病 (CrCl<30mL/min) 或透析期间，但 DOAC 是轻度至中度 CKD 患者的合理选择。
