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Historically, warfarin has been the anticoagulant of choice for patients with advanced kidney disease. Although the package insert for apixaban permits its use for patients with end-stage renal disease (ESRD), the recommendation is based largely on pharmacokinetic data from a small sample of patients. Accordingly, hematologists have been reluctant to prescribe apixaban for patients with advanced kidney disease. However, results from retrospective studies addressing the safety and efficacy of apixaban in this patient population are emerging.
In a new retrospective cohort study, investigators evaluated anticoagulation treatment for 861 patients with ESRD (creatinine clearance, <25 mL/min) at four health systems across Southeastern Michigan. Of…