Evidence map›Paper›PMID 40949128›Full record

SynthesisFrontiers in pharmacology2025

Efficacy and safety of oral anticoagulants in the treatment of chronic kidney disease with atrial fibrillation or venous thromboembolism: a systematic review and meta-analysis.

Qinan Yin, Xingyue Zheng, Xiaoqing Ni, Yin Wang, Xuefei Huang, Yujie Song, Lizhu Han, Youjin Huang, Yuan Bian

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Direct Oral Anticoagulants Increase Overall but Not Major Bleeding in Critically Ill Chronic Kidney Disease Patients With Pulmonary Embolism.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Qinan Yin *Department of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Xingyue Zheng *Department of Pharmacy, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Xiaoqing Ni *Department of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Yin WangDepartment of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Xuefei HuangDepartment of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Yujie SongDepartment of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Lizhu HanDepartment of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Youjin HuangDepartment of Vascular Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Yuan BianDepartment of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The choice of oral anticoagulants for patients with Chronic Kidney Disease (CKD) combined with venous thromboembolism (VTE) or atrial fibrillation (AF) remains controversial. Objective: To compare the efficacy and safety of warfarin and direct oral anticoagulants (DOACs) in the treatment of CKD with atrial fibrillation or venous thromboembolism. Methods: Relevant publications were sourced from databases like PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov up to 30 June 2024. Only RCTs assessing the efficacy and safety of warfarin and DOACs for treating CKD with AF or VTE were included in the meta-analysis. The review outcomes are thrombosis recurrence or VTE-related deaths and major bleeding for CKD patients with VTE, and stroke or systemic embolism and major bleeding for CKD patients with AF. The risk of bias in all included studies was evaluated using the Cochrane Collaboration's tool. Results: After reviewing 540 studies, 15 randomized controlled trials (RCTs) with 16,361 participants were included. The study found that DOACs reduced the risk of hemorrhagic stroke compared to warfarin in patients with AF and CKD (RR = 0.455, 95% CI: 0.275-0.752, P = 0.002). There was no significant difference in ischemic stroke incidence between the two. DOACs also lowered the risk of major bleeding in patients with AF and CKD compared to warfarin (RR = 0.604, 95% CI: 0.442-0.825, P = 0.002), and significantly reduced the risk of intracranial bleeding (RR = 0.424, 95% CI: 0.287-0.626, P < 0.001). All five studies reported recurrent VTE or VTE-related deaths, showing no significant difference between warfarin and DOAC groups (RR = 0.663, 95% CI: 0.409-1.073, P = 0.094), Patients with renal dysfunction on either treatment had similar risks of major bleeding events (RR = 0.543, 95% CI: 0.209-1.407, P = 0.208). Conclusion: DOACs demonstrate superior efficacy and safety compared to warfarin in patients with AF and CKD. Additionally, DOACs exhibit comparable efficacy and safety to warfarin in patients with VTE and CKD. Systematic Review Registration: http://www.clinicaltrials.gov, identifier (CRD42024510727).

Indexed as

atrial fibrillationchronic kidney diseaseoral anticoagulationsystematic reviewvenous thromboembolism

Identifiers

PMID40949128
PMCPMC12425454

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.