Influence of kidney function on risk of supratherapeutic international normalized ratio-related hemorrhage in warfarin users: a prospective cohort study.

ABSTRACT:

Background

Anticoagulation management is difficult in chronic kidney disease, with frequent supratherapeutic international normalized ratios (INRs ≥ 4) increasing hemorrhagic risk. We evaluated whether the interaction of INR and lower estimated glomerular filtration rate (eGFR) increases hemorrhage risk and whether patients with lower eGFRs experience slower anticoagulation reversal.

Study design

Prospective cohort study.

Setting & participants

Warfarin pharmacogenetics cohort (1,273 long-term warfarin users); warfarin reversal cohort (74 warfarin users admitted with INRs ≥ 4).

Predictor

eGFR, INR as time-dependent covariate, and their interaction in the pharmacogenetics cohort; eGFR in the reversal cohort.

Outcomes & measurements

In the pharmacogenetics

SUBMITTER: Limdi NA 

PROVIDER: S-EPMC4414676 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature