August 2nd, 2019

Podcast 227: Chronic kidney disease and anticoagulants

(1 votes, average: 4.00 out of 5)

Chronic kidney disease, being a “prothrombic state,” would seem to warrant use of anticoagulants, yet they aren’t often used — why? The problem seems to be a lack of data with which to evaluate their effectiveness and possible harms. Big drug trials seem to avoid recruiting these patients, especially those in the later stages of CKD, where, for example, the risk for thromboembolism is two- to three-fold greater than in patients with normal kidney function.

We talk with Dr. Sunil Badve, senior author of a meta-analysis in a recent Annals of Internal Medicine. His findings? Non-vitamin K oral anticoagulants (or “NOACs”) seem better suited for those with early-stage disease than vitamin K antagonists like warfarin. In later-stage CKD, there just isn’t enough data available yet, and so the choice of therapy — if any — must weigh benefits against harms carefully.

Links:

Annals of Internal Medicine meta-analysis

Physician’s First Watch coverage

4 Responses to “Podcast 227: Chronic kidney disease and anticoagulants”

  1. Israel H. Konefka-Kronenberg says:

    Thanks for the update.
    Greetings from Caracas, Venezuela .

  2. Noemy Barberan says:

    Dear Physician first watch team,

    I want to congratulate you for this very helpful feature offered to all whom belongs to the medical community. Have the chance to listen all these news give us a time effective way to be updated with reliable information.
    I am very confident that this project will be one more of the many upcoming successes.
    Thanks again and many blessings.

    Very Respectfully,
    Noemy Barberan, MD. MPA.

  3. Thank you for the podcast.

    I was glad to listen and found the conversation helpful. I do have a suggestion on your overall format.

    As a primary care doc, I would like to hear, in addition to the data presentations, the voice and opinion of a practicing clinical doctor regarding the top stories you present. I think your podcast would be stronger to include this analysis.

    In our age of EMR we have lost much of our physician conversations sharing our clinical synthesis of data through the lens of medical experience and acquired knowledge. As a primary care doc I still seek out specialists I trust for their opinion knowing it is just that- an opinion. But it is invaluable in helping me integrate and best understand new ideas and data.

    I hope you will consider adding this aspect to your podcast. I listen to a daily world news podcast where first the news report is given and then two political commentators discuss their analysis of the news reports. They are clear about their biases and their analysis often differs.. It will help us in medicine to hold onto to value of opinion analysis in addition to reporting the facts. Your podcast is a perfect opportunity to offer this. I would find it very useful in our age of fewer doctor curbside opportunities.

  4. Dhanpal Manakapure says:

    Wait & Watch.We have to Adjust.Anyhow Very Good Idea. Thanks A Lot.

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