Rivaroxaban and Chronic Kidney Disease: evidence from the present and future prospects
Cardiovascular diseases represent the main cause of comorbidly in chronic kidney disease (CKD) patients, with a 7% incidence in atrial fibrillation (AF) in end-stage renal disease (ESRD) patients.
Until recently, prophylactic treatment of atrial fibrillation complications (such as thromboembolism) was mainly based on vitamin K antagonists (VKA) or heparin.
In the last years, direct oral anticoagulants (DOACs) have been made available; however, their renal clearance limits their use on patients with severe renal impairment (eGFR <15 mL/min). Among DOACs, Rivaroxaban, a factor X-activated (Xa) inhibitor, shows good renal profile and it can be used in CKD patients up to stage 4 as well as in ESRD patients (at the moment only in North America and Canada).
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