Bleeding Risk in Warfarin-Treated Patients with Kidney Disease

When international normalized ratio was ≥4, major bleeding was more likely in patients with estimated glomerular filtration rates <45 mL/minute/1.73 m².

According to official prescribing information for warfarin, no dosage adjustment is necessary for renal impairment. However, researchers have shown that warfarin-treated patients with substantially impaired renal function require lower warfarin doses, are more likely to have international normalized ratios (INRs) outside the therapeutic range, and are at higher risk for major hemorrhage (J Am Soc Nephrol 2009; 20:912; NEJM JW Gen Med Mar 15 2015 and BMJ 2015; 350:h246). Now, researchers have examined the interaction between supratherapeutic INR (≥4), renal function (assessed using estimated glomerular filtration rate [eGFR]), and bleeding risk in 1273 long-term warfarin users.

During average follow-up of about 1.5 years, roughly 34,000 INR t…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Bleeding Risk in Warfarin-Treated Patients with Kidney Disease

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Reviewing Author