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UK prescribing practice of anticoagulants in patients with chronic kidney disease: a nephrology and haematology-based survey.
Parker, Kathrine; Choudhuri, Satarupa; Lewis, Penny; Thachil, Jecko; Mitra, Sandip.
Afiliação
  • Parker K; Manchester Institute of Nephrology and Transplantation, Manchester University NHS Foundation Trust, Oxford Road, M13 9WL, Manchester, UK. Kathrine.parker@postgrad.manchester.ac.uk.
  • Choudhuri S; Division of pharmacy and optometry, School of health sciences, Manchester Academic Health Science Centre, The University of Manchester, University of Manchester, M13 9PT, Manchester, UK. Kathrine.parker@postgrad.manchester.ac.uk.
  • Lewis P; Department of Haematology, Northern Care Alliance NHS Foundation Trust, Royal Oldham hospital, Rochdale Rd, OL1 2JH, Oldham, UK.
  • Thachil J; Division of pharmacy and optometry, School of health sciences, Manchester Academic Health Science Centre, The University of Manchester, University of Manchester, M13 9PT, Manchester, UK.
  • Mitra S; Department of Haematology, Manchester University NHS Foundation Trust, Oxford Road, M13 9WL, Manchester, UK.
BMC Nephrol ; 24(1): 9, 2023 01 12.
Article em En | MEDLINE | ID: mdl-36635661
ABSTRACT
A survey to gain insight into anticoagulant prescribing practice in the setting of chronic kidney disease (CKD) across the UK was disseminated via renal and haematology networks. Areas of anticoagulant use included patients with venous thromboembolism (VTE), requiring thromboprophylaxis for VTE, Atrial Fibrillation (AF) and nephrotic syndrome.An online-survey was disseminated via British Haematology Society, UK Kidney Association, and Renal Pharmacy Group over a five month period. All responses were voluntary and anonymous.Among 117 responses there were 49 nephrology doctors, 47 renal pharmacists and 20 haematology clinicians. A specialist multidisciplinary team to discuss the specific anticoagulant management of these patients was only available to 3% (4/117) respondents. Renal function estimate used for anticoagulant dosing was mainly Cockcroft-Gault for pharmacists and haematology but lab-based estimates were used by nephrology doctors. Therapeutic dose of Low Molecular Weight Heparin was mostly likely to be reduced by one-third when used for VTE treatment, with the majority of units undertaking anti-Xa monitoring in CKD stage 5 and dialysis. Direct-acting Oral Anticoagulants are being used in patients with nephrotic syndrome, those with CKD stage 5 and on dialysis for VTE and AF in the absence of license in these indications.This survey highlighted the significant differences between anticoagulant prescribing in CKD between two professional specialties and marked variation between centres in anticoagulant management strategies employed for these patients. With gaps still existing in the evidence base and answers to these not expected within the next few years, development of a best-practice guideline would be warranted to support clinicians in this field.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Insuficiência Renal Crônica / Tromboembolia Venosa / Hematologia / Falência Renal Crônica / Nefrologia / Síndrome Nefrótica Tipo de estudo: Guideline / Qualitative_research Limite: Humans País/Região como assunto: Europa Idioma: En Revista: BMC Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Insuficiência Renal Crônica / Tromboembolia Venosa / Hematologia / Falência Renal Crônica / Nefrologia / Síndrome Nefrótica Tipo de estudo: Guideline / Qualitative_research Limite: Humans País/Região como assunto: Europa Idioma: En Revista: BMC Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Reino Unido