慢性肾脏病患者口服抗凝药物临床应用的研究进展

Research Progress on the Clinical Application of Oral Anticoagulants in Patients with Chronic Kidney Disease

慢性肾脏病(chronic kidney disease, CKD)已然成为一个全球公认的公共卫生问题,普遍认为CKD和心脑血管疾病(cerebrovascular disease, CVD)会互相影响彼此相关的结局,合理管理CVD可以延缓CKD病情进展,随着维生素K拮抗剂华法林的广泛应用和新型口服抗凝药物的引入,在预防血栓栓塞发生的同时也可能增加并发肾损伤的风险,并且在晚期CKD患者中,口服抗凝药的应用以及根据肾功能进行剂量调整的争议依然存在。本文对目前CKD患者口服抗凝药物的应用进行综述,旨在为肾功能受损患者提供个性化的治疗决策。

Chronic kidney disease (CKD) has become a globally recognized public health problem, it is gener-ally believed that CKD and cerebrovascular disease (CVD) will affect each other in related outcomes, reasonable management of CVD can delay the progression of CKD, with the widespread use of the vitamin K antagonist warfarin and the introduction of new oral anticoagulants, while preventing thromboembolism, it may also increase the risk of concurrent renal injury, and the use of oral anti-coagulants and dose adjustment according to renal function remain controversial in patients with advanced CKD. This article reviews the current use of oral anticoagulants in patients with CKD, aiming to provide personalized treatment decisions for patients with impaired renal function.