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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Renal profiles of anticoagulants
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Renal profiles of anticoagulants

机译：抗凝剂的肾脏特征

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摘要

Anticoagulants are widely used to prevent and treat venous thromboembolism, prevent stroke in atrial fibrillation, and manage acute coronary syndrome. These drugs are often used in elderly patients, who commonly have renal impairment, comorbidities, and polypharmacy. Renal impairment is a risk factor for bleeding and thrombosis during anticoagulant therapy and can influence the balance between the safety and efficacy of such agents. Some of the more established anticoagulants, such as the low-molecular-weight heparins, warfarin, and fondaparinux, are contraindicated for use in patients with severe renal impairment. Of the new oral anticoagulants, dabigatran etexilate, rivaroxaban, and apixaban are at the most advanced stages of development. Dabigatran requires dose adjustment in patients with moderate renal impairment and is contraindicated in patients with severe renal impairment. Rivaroxaban can be administered as a fixed dose for the prevention of venous thromboembolism in patients with moderate renal impairment and should be used with caution in patients with severe renal impairment. Apixaban excretion is also partly dependent on renal function, although the impact of renal insufficiency has not been determined. Additional data on the safety of chronic dosing of the newer oral anticoagulants in renal impairment are awaited.
机译：抗凝剂广泛用于预防和治疗静脉血栓栓塞，预防房颤的中风和管理急性冠状动脉综合征。这些药物通常用于通常患有肾功能不全，合并症和多药的老年患者。肾功能不全是抗凝治疗期间出血和血栓形成的危险因素，可能会影响此类药物的安全性和功效之间的平衡。禁止将某些较成熟的抗凝剂（例如低分子量肝素，华法林和磺达肝癸钠）用于严重肾功能不全的患者。在新的口服抗凝剂中，达比加群酯，利伐沙班和阿哌沙班处于开发的最高级阶段。达比加群在中度肾功能不全患者中需要调整剂量，在重度肾功能不全患者中禁用。利伐沙班可以以固定剂量给药，以预防中度肾功能不全患者的静脉血栓栓塞，严重肾功能不全的患者应谨慎使用。尽管尚未确定肾功能不全的影响，但阿哌沙班的排泄也部分取决于肾脏功能。还需要有关慢性口服新型抗凝剂在肾功能损害中长期服用的安全性的其他数据。

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