{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:37:59Z","timestamp":1784281079099,"version":"3.55.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004836","name":"Independent Research Fund Denmark","doi-asserted-by":"publisher","award":["1057-00037B"],"award-info":[{"award-number":["1057-00037B"]}],"id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004836","name":"Independent Research Fund Denmark","doi-asserted-by":"publisher","award":["0134-00407B"],"award-info":[{"award-number":["0134-00407B"]}],"id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["#2019-01059"],"award-info":[{"award-number":["#2019-01059"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Swedish Heart-Lung Foundation","doi-asserted-by":"publisher","award":["1870"],"award-info":[{"award-number":["1870"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021851","name":"William Demant Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021851","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007438","name":"Hede Nielsen Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007438","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007403","name":"Dagmar Marshalls Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007403","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Direct oral anticoagulants (DOACs) are recommended as first-line treatment of atrial fibrillation. Whether DOAC use is associated with lower risks of kidney complications compared with vitamin K antagonists (VKAs) remains unclear. We examined this association in a nationwide, population-based cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a cohort study including patients initiating oral anticoagulant treatment within 3\u00a0months after an atrial fibrillation diagnosis in Denmark during 2012\u201318. Using routinely collected creatinine measurements from laboratory databases, we followed patients in an intention-to-treat approach for acute kidney injury (AKI) and chronic kidney disease (CKD) progression. We used propensity-score weighting to balance baseline confounders, computed weighted risks and weighted hazard ratios (HRs) with 95% confidence intervals (CIs) comparing DOACs with VKAs. We performed several subgroup analyses and a per-protocol analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 32\u2009781 persons with atrial fibrillation initiating oral anticoagulation (77% initiating DOACs). The median age was 75\u00a0years, 25% had a baseline estimated glomerular filtration rate &amp;lt;60\u00a0mL\/min\/1.73 m2, and median follow-up was 2.3 (interquartile range 1.1\u20133.9) years. The weighted 1-year risks of AKI were 13.6% in DOAC users and 15.0% in VKA users (HR 0.86, 95% CI 0.82; 0.91). The weighted 5-year risks of CKD progression were 13.9% in DOAC users and 15.4% in VKA users (HR 0.85, 95% CI 0.79; 0.92). Results were similar across subgroups and in the per-protocol analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Initiation of DOACs was associated with a decreased risk of AKI and CKD progression compared with VKAs. Despite the potential limitations of observational studies, our findings support the need for increased clinical awareness to prevent kidney complications among patients who initiate oral anticoagulants.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfad252","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T08:10:43Z","timestamp":1696407043000},"source":"Crossref","is-referenced-by-count":7,"title":["Oral anticoagulant treatment and risk of kidney disease\u2014a nationwide, population-based cohort study"],"prefix":"10.1093","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5284-9469","authenticated-orcid":false,"given":"Ane Emilie Friis","family":"Vestergaard","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0032-131X","authenticated-orcid":false,"given":"Simon Kok","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uffe","family":"Heide-J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper","family":"Adelborg","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus , Denmark"},{"name":"Department of Clinical Biochemistry, G\u00f8dstrup Regional Hospital, G\u00f8dstrup , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Birn","sequence":"additional","affiliation":[{"name":"Departments of Biomedicine and Clinical Medicine, Aarhus University, Aarhus , Denmark"},{"name":"Department of Renal Medicine, Aarhus University Hospital, Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4763-2024","authenticated-orcid":false,"given":"Juan-Jesus","family":"Carrero","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatisctics, Karolinska Institutet, Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Fynbo","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"2024020711401983000_bib1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"key":"2024020711401983000_bib2","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/S0140-6736(13)62343-0","article-title":"Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials","volume":"383","author":"Ruff","year":"2014","journal-title":"Lancet"},{"key":"2024020711401983000_bib3","journal-title":"DCS. 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