Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Kidney disease affects response to blood thinner

20.02.2009
Patients with reduced kidney function may need lower doses of warfarin

Patients with reduced kidney function require lower doses of the anticoagulant drug warfarin, and may need closer monitoring to avoid serious bleeding complications, suggests a study in the April 2009 issue of the Journal of the American Society of Nephrology (JASN).

Among patients who take blood thinner there is a high prevalence of reduced kidney function, ranging from mild to severe. "Although warfarin is very effective in protecting against blood clots it can also cause serious bleeding complications," commented lead author Nita A. Limdi, PharmD, PhD, of the University of Alabama at Birmingham. "The information in our study may help doctors customize warfarin management in patients with kidney failure and lower the risk of complications," commented Michael Allon, MD, also of the University of Alabama at Birmingham.

The researchers evaluated responses to warfarin, the most widely used oral anticoagulant drug, in 578 patients. About 60 percent of the patients had normal or mildly reduced kidney function. Another 30 percent had moderate reductions in kidney function, common in older adults. The remaining patients, nearly ten percent, had kidney failure requiring dialysis.

Warfarin dose was significantly affected by kidney function. The influence of kidney function remained significant even after accounting for medications and the two genes (CYP2C9 and VKORC1) that have been shown to influence warfarin dose. For dialysis patients with kidney failure, a lower dose of warfarin achieved the desired blood-thinning effect. Patients with kidney failure were also more likely to develop serious bleeding complications related to warfarin, regardless of other risk factors. "Patients with renal failure may require closer monitoring to maintain their warfarin in the desired range," said Dr. Limdi.

Even moderately reduced kidney function affected patients' response to blood thinner. These patients also required a lower dose of warfarin, although they were not at increased risk of serious bleeding. The results have important implications for a large proportion of patients who take warfarin. "Warfarin therapy is prescribed and managed similarly in patients with reduced kidney function as in the general medical population," according to Dr. Allon. "However, in our study patients with reduced renal function and renal failure required lower doses. Forty percent of study participants fell into these categories. This highlights that kidney function may be an important factor to consider in patients being prescribed warfarin," said Dr. Limdi.

Patients with kidney failure are at higher risk of serious bleeding. "Further studies are required to understand the harm and benefit associated with warfarin therapy in patients with kidney failure," said Dr. Limdi.

The study had some important limitations, including a lack of data on patients who developed blood clots despite being on warfarin. "Therefore we hesitate to recommend the use of kidney function in making treatment decisions," Dr. Limdi added. "Perhaps ongoing and future research efforts evaluating both clotting and bleeding events will enable more balanced clinical decision making in this unique and medically challenging patient population."

Shari Leventhal | EurekAlert!
Further information:
http://www.asn-online.org

More articles from Studies and Analyses:

nachricht The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>