Canadian Society of Nephrology (CSN) in America 2019

Canadian Society of Nephrology (CSN) in America 2019 is organized by Canadian Society of Nephrology (CSN) / Societe canadienne de Nephrologie (SCN) and will be held on Nov 06, 2019 at Andrew W Mellon Auditorium, Washington, Dist of Col, United States of America.

Description:
Compared to the general population, the risk of venous thromboembolism (VTE) and atrial fibrillation (AF) is 2-3 times greater and 10-20 times greater in patients with chronic kidney disease (CKD) and end stage kidney disease (ESKD). VTE in ESKD is associated with an increased risk of mortality; atrial fibrillation is associated with an increased risk of stroke and mortality. Advanced age, hypertension, diabetes mellitus and congestive heart failure are highly prevalent in people with CKD and ESKD such that the majority of patients would require venous thromboembolism prophylaxis when hospitalized and/or anticoagulation for their AF based on guidelines developed for the general population. However, patients with CKD and ESKD have a significantly increased risk of bleeding compared with the general population when treated with warfarin anticoagulation. Warfarin has also been associated with an increased risk of valvular calcification and calcific uremic arteriolopathy in this patient population. Thus, the risk-benefit ratio of warfarin therapy is uncertain in patients with CKD and ESKD as this patient population was excluded from the randomized controlled trials; this equipoise is reflected in the tremendous variability in warfarin use in AF in patients with ESKD. With emerging evidence of increased efficacy and safety of the non-vitamin K oral anticoagulants (NOAC) in the general population, there is a renewed interest in the role of anticoagulant therapy for prevention of stroke and venous thromboembolism in CKD and ESKD

Objectives:
To determine if there is evidence in CKD/ESKD to use NOACs instead of warfarin in patients who require systemic anticoagulation.

Additional details will be posted as soon as they are available.