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Anticoagulation Therapy in Patients with Chronic Kidney Disease

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Thrombosis and Embolism: from Research to Clinical Practice

Part of the book series: Advances in Experimental Medicine and Biology ((AIM,volume 906))

Abstract

Patients with chronic kidney disease (CKD) are at increased risk for both thrombotic events and bleeding. The early stages of CKD are mainly associated with prothrombotic tendency, whereas in its more advanced stages, beside the prothrombotic state, platelets can become dysfunctional due to uremic-related toxin exposure leading to an increased bleeding tendency. Patients with CKD usually require anticoagulation therapy for treatment or prevention of thromboembolic diseases. However, this benefit could easily be offset by the risk of anticoagulant-induced bleeding. Treatment of patients with CKD should be based on evidence from randomized clinical trials, but usually CKD patients are excluded from these trials. In the past, unfractionated heparins were the anticoagulant of choice for patients with CKD because of its independence of kidney elimination. However, currently low-molecular-weight heparins have largely replaced the use of unfractionated heparins owing to fewer incidences of heparin-induced thrombocytopenia and bleeding. We undertook this review in order to explain the practical considerations for the management of anticoagulation in these high risk population.

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Authors and Affiliations

  1. School of Pharmacy, Universiti Sains Malaysia, Penang, Malaysia

    Fatemeh Saheb Sharif-Askari M. Pharm, Ph.D., Syed Azhar Syed Sulaiman Pharm.D & Narjes Saheb Sharif-Askari M. Pharm, Ph.D

  2. Dubai, 29005, United Arab Emirates

    Fatemeh Saheb Sharif-Askari M. Pharm, Ph.D.

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  1. Fatemeh Saheb Sharif-Askari M. Pharm, Ph.D.
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  2. Syed Azhar Syed Sulaiman Pharm.D
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  3. Narjes Saheb Sharif-Askari M. Pharm, Ph.D
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Correspondence to Fatemeh Saheb Sharif-Askari M. Pharm, Ph.D. .

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  1. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Md. Shahidul Islam

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Saheb Sharif-Askari, F., Syed Sulaiman, S.A., Saheb Sharif-Askari, N. (2016). Anticoagulation Therapy in Patients with Chronic Kidney Disease. In: Islam, M. (eds) Thrombosis and Embolism: from Research to Clinical Practice. Advances in Experimental Medicine and Biology(), vol 906. Springer, Cham. https://doi.org/10.1007/5584_2016_109

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  • DOI: https://doi.org/10.1007/5584_2016_109

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