{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:07:42Z","timestamp":1792789662986,"version":"4.5.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the role of oral anticoagulation in patients with stage 5 chronic kidney disease (CKD-5) or end-stage kidney disease (ESKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>A literature search of PubMed (January 2000 to July 1, 2021), the Cochrane Library, and Google Scholar databases (through April 1, 2021) was performed with keywords DOAC (direct-acting oral anticoagulant) OR NOAC or dabigatran OR rivaroxaban OR apixaban OR edoxaban AND end-stage kidney disease combined with atrial fibrillation (AF) or venous thromboembolism (VTE) OR pulmonary embolism OR deep-vein thrombosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>Case-control, cohort, and randomized controlled trials comparing DOACs to an active control for AF or VTE in patients with CKD-5 or ESKD and reporting outcomes of stroke, recurrent thromboembolism, or major bleeding were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Nine studies were included. Efficacy data supporting routine use of warfarin or DOACs in CKD-5 or ESKD are limited. Rivaroxaban and apixaban may provide enhanced safety compared to warfarin in patients with AF. Data for VTE are limited to 1 retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Patient Care and Clinical Practice:<\/jats:title>\n                    <jats:p>Because of the paucity of rigorous, prospective studies in CKD-5 or ESKD, OACs should not be broadly used in this population. It is clear that data regarding efficacy of DOACs cannot be reliably and safely extrapolated from the non-ESKD population. Therefore, use of OACs in this population should be individualized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>If OACs for stroke prevention with AF are deemed necessary, apixaban or rivaroxaban can be considered. DOACs cannot currently be recommended over warfarin in patients with CKD-5 or ESKD and VTE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280211040093","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T01:27:42Z","timestamp":1630286862000},"page":"691-703","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["A Review of Direct Oral Anticoagulants in Patients With Stage 5 or End-Stage Kidney Disease"],"prefix":"10.1177","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-4372","authenticated-orcid":false,"given":"Jessica A.","family":"Starr","sequence":"first","affiliation":[{"name":"Auburn University, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1938-5951","authenticated-orcid":false,"given":"Nathan A.","family":"Pinner","sequence":"additional","affiliation":[{"name":"Auburn University, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Mannis","sequence":"additional","affiliation":[{"name":"Samford University, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Katherine","family":"Stuart","sequence":"additional","affiliation":[{"name":"Baptist Princeton Medical Center, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,8,29]]},"reference":[{"key":"bibr1-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"bibr2-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"bibr3-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.07.040"},{"key":"bibr4-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy136"},{"key":"bibr5-10600280211040093","unstructured":"Coumadin. Package insert. Bristol-Meyers Squibb Company; 2017. Accessed July 12, 2021. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/009218s118lbl.pdf"},{"key":"bibr6-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1007\/s13318-018-0501-y"},{"key":"bibr7-10600280211040093","unstructured":"US Department of Health and Human Services; Food and Drug Administration Center; Drug Evaluation and Research (CDER). Guidance for industry: pharmacokinetics in patients with impaired renal function\u2014study design, data analysis, and impact on dosing. Accessed May 4, 2021. https:\/\/www.fda.gov\/media\/78573\/download"},{"key":"bibr8-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1159\/000445328"},{"key":"bibr9-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.628"},{"key":"bibr10-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0730"},{"key":"bibr11-10600280211040093","volume-title":"2020 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"United States Renal Data System","year":"2020"},{"key":"bibr12-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.08.003"},{"key":"bibr13-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2011.223"},{"key":"bibr14-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1160\/TH16-11-0876"},{"key":"bibr15-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"bibr16-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.03.027"},{"key":"bibr17-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016689265"},{"key":"bibr18-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.05.005"},{"key":"bibr19-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-1719"},{"key":"bibr20-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.02.004"},{"key":"bibr21-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2016-000441"},{"key":"bibr22-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.2175"},{"key":"bibr23-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-016-0368-6"},{"key":"bibr24-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.09.016"},{"key":"bibr25-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-214142"},{"key":"bibr26-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V122326"},{"key":"bibr27-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008070802"},{"key":"bibr28-10600280211040093","unstructured":"Eliquis. Package insert. Bristol-Myers Squibb Company; 2019. Accessed April 19, 2021. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2019\/202155s024lbl.pdf"},{"key":"bibr29-10600280211040093","unstructured":"Xarelto. Package insert. Janssen Pharmaceuticals Inc; 2021. Accessed April 19, 2021. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2021\/022406s036,202439s036lbl.pdf"},{"key":"bibr30-10600280211040093","unstructured":"Pradaxa. Package insert. Boehringer Ingelheim Pharmaceuticals Inc; 2020. Accessed April 19, 2021. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2020\/022512s039lbl.pdf"},{"key":"bibr31-10600280211040093","unstructured":"Savaysa. Package insert. Daiichi Sankyo Inc; 2020. Accessed April 19, 2021. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2020\/206316s016lbl.pdf"},{"key":"bibr32-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e32832ee371"},{"key":"bibr33-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007030308"},{"key":"bibr34-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12652"},{"key":"bibr35-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfx212"},{"key":"bibr36-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2015.11.026"},{"key":"bibr37-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249940"},{"key":"bibr38-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2019060579"},{"key":"bibr39-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2020111566"},{"key":"bibr40-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13599"},{"key":"bibr41-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-020-07108-4"},{"key":"bibr42-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1177\/1060028019897053"},{"key":"bibr43-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035418"},{"key":"bibr44-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12083"},{"key":"bibr45-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1177\/1060028017694654"},{"key":"bibr46-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13383"},{"key":"bibr47-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-08-0573"},{"key":"bibr48-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.335"},{"key":"bibr49-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13208"},{"key":"bibr50-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1160\/th14-06-0547"},{"key":"bibr51-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2016090980"},{"key":"bibr52-10600280211040093","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.01.022"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280211040093","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10600280211040093","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280211040093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:16:26Z","timestamp":1777374986000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10600280211040093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,29]]},"references-count":52,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1177\/10600280211040093"],"URL":"https:\/\/doi.org\/10.1177\/10600280211040093","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,29]]}}}