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According to warfarin's prescribing information, “no dosage adjustment is necessary for patients with renal failure.” However, a new study suggests that this issue deserves another look.
Researchers analyzed data on 980 patients whose warfarin therapy was monitored in anticoagulation clinics in Chicago and in Birmingham, Alabama. In analyses adjusted for various clinical, demographic, and genetic factors that could affect warfarin dosing, the average warfarin dose required to maintain a therapeutic international normalized ratio (INR) varied as a function of estimated glomerular filtration rate (eGFR, expressed as mL/minute/1.73 m2). Compared with patients whose eGFRs were ≥60, the average warfarin doses for those with eGFRs of 30–59 and <30…