Featured Research

from universities, journals, and other organizations

Kidney Disease Affects Response To Blood Thinner

Date:
March 1, 2009
Source:
American Society of Nephrology
Summary:
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 new study.

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 new study.

Related Articles


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."

The National Heart Lung and Blood Institute and the National Institute of Neurological Disorders and Stroke provided funding for this study.


Story Source:

The above story is based on materials provided by American Society of Nephrology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Nita A. Limdi, T. Mark Beasley, Melissa F. Baird, Joyce A. Goldstein, Gerald McGwin, Donna K. Arnett, Ronald T. Acton, and Michael Allon. Kidney Function Influences Warfarin Responsiveness and Hemorrhagic Complications. J Am Soc Nephrol, 2009; DOI: 10.1681/ASN.2008070802

Cite This Page:

American Society of Nephrology. "Kidney Disease Affects Response To Blood Thinner." ScienceDaily. ScienceDaily, 1 March 2009. <www.sciencedaily.com/releases/2009/02/090218181806.htm>.
American Society of Nephrology. (2009, March 1). Kidney Disease Affects Response To Blood Thinner. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2009/02/090218181806.htm
American Society of Nephrology. "Kidney Disease Affects Response To Blood Thinner." ScienceDaily. www.sciencedaily.com/releases/2009/02/090218181806.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins