Comparison of renal function estimation formulae for dosing direct oral anticoagulants in patients with atrial fibrillation

Kwang No Lee, Jong Il Choi, Yun Gi Kim, Ki Yung Boo, Do Young Kim, Yun Young Choi, Ha Young Choi, Dong Hyeok Kim, Dae In Lee, Seung Young Roh, Jaemin Shim, Jin-Seok Kim, Young Hoon Kim

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

The Cockcroft-Gault (CG) formula is recommended to guide clinicians in the choice of the appropriate dosage for direct oral anticoagulants (DOACs). However, the performance of the CG formula varies depending on the patient’s age, weight, and degree of renal function. We aimed to compare the validity of the CG formula with that of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) formulae for dosing DOACs. A total of 6268 consecutive patients on anticoagulants for atrial fibrillation (AF) were retrospectively investigated. Among underweight and elderly patients, the CG formula underestimated renal function compared with the non-CG formulae. However, the concordant rate of drug indications between the CG and the non-CG formulae was approximately 94%. On-label uses under the three formulae were associated with a lower risk of major bleeding (but not thromboembolism) compared to warfarin. Although we found differences in estimating renal function and the proportions of drug indications between the CG and non-CG formulae, the risks of thromboembolism and major bleeding were similar to those with warfarin regardless of which formula was used.

Original languageEnglish
Article number2034
JournalJournal of Clinical Medicine
Volume8
Issue number12
DOIs
Publication statusPublished - 2019 Dec

Keywords

  • Anticoagulant
  • Atrial fibrillation
  • Product labeling
  • Renal elimination
  • Warfarin

ASJC Scopus subject areas

  • Medicine(all)

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