title: Atrial fibrillation and chronic kidney disease: focus on rivaroxaban.
abstract: Renal insufficiency increases the risk of stroke and bleeding in atrial fibrillation patients. Although vitamin K antagonists reduce the risk of stroke in patients with moderate renal dysfunction, this observation is less clear in patients with renal impairment. Moreover, the risk of bleeding with vitamin K antagonists increases as renal function worsens. Maintaining international normalized ratio values within therapeutic targets is more difficult in patients with renal dysfunction, and those agents may cause warfarin-related nephropathy and vascular calcification. Rivaroxaban is the only nonvitamin K oral anticoagulant with a dose specifically tested in patients with moderate renal insufficiency. Rivaroxaban is effective for the prevention of stroke in atrial fibrillation patients with moderate renal dysfunction, with a lower risk of intracranial and fatal bleeding.
authors.affiliation: Department of Cardiology, University Hospital Ramón y Cajal, School of Medicine, Alcalá University, Madrid, Spain.
authors.forename: Vivencio
authors.initials: V
authors.lastname: Barrios
authors.affiliation: Department of Nephrology, Doctor Peset University Hospital, Department of Medicine, University of Valencia, Valencia, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Górriz
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000453:epidemiology; D000069552:Rivaroxaban / Q000008:administration & dosage*; D020521:Stroke / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D014812:Vitamin K; D014859:Warfarin; D000069552:Rivaroxaban
keywords: atrial fibrillation; chronic kidney disease; new oral anticoagulant; nonvitamin K oral anticoagulant; renal function; renal insufficiency; rivaroxaban; vitamin K antagonist