acenocoumarol and Kidney-Failure--Chronic

The purpose of this review article is to summarize the literature on diseases that are documented to have an effect on response to warfarin and other VKAs.. We searched the English literature from 1946 to September 2015 via PubMed, EMBASE, and Scopus for the effect of diseases on response vitamin K antagonists including warfarin, acenocoumarol, phenprocoumon, and fluindione.. Among many factors modifying response to VKAs, several disease states are clinically relevant. Liver disease, hyperthyroidism, and CKD are well documented to increase response to VKAs. Decompensated heart failure, fever, and diarrhea may also elevate response to VKAs, but more study is needed. Hypothyroidism is associated with decreased effect of VKAs, and obese patients will likely require higher initial doses of VKAs.. In order to minimize risks with VKAs while ensuring efficacy, clinicians must be aware of the effect of disease states when prescribing these oral anticoagulants.

Topics: Acenocoumarol; Administration, Oral; Anticoagulants; Cardiovascular Diseases; Diarrhea; Fibrinolytic Agents; Heart Failure; Humans; Hyperthyroidism; Kidney Failure, Chronic; Liver Diseases; Obesity; Phenindione; Phenprocoumon; Vitamin K; Warfarin

To analyze the environmental factors associated to anticoagulation excess in adult patients who come to an emergency department of a tertiary hospital. To describe the characteristics of anticoagulant therapy, their diseases and associated drugs, clinical presentation and treatment received.. Prospective study of randomized patients conducted in the Emergency Department of Hospital Gregorio Marañón in Madrid during 6 months. Those patients whose INR was greater than or equal to 6 due to having taken acenocoumarol were included. Variables collected for all of them were: age, gender, INR when coming to the emergency department, anticoagulation indication, its beginning and duration, physician anticoagulation controlling, time since previous INR control, last INR assessment, treatment changes. Other variables were: comorbidity, associated medications, dietary changes, presence of bleeding, its location and treatment received. The statistical analysis was performed with the SPSS program (vs 13).. A total of 49 adult patients, 63.3% female, whose average age was 77.9 (48-94) were included. Mean INR value was 8.2 (6-12). Indication due to atrial fibrillation was found in 71.4%. The most common associated diseases were heart failure and chronic nephropathy (18.4% and 16.3%, respectively). Twelve patients (24.5%) had consumed paracetamol recently. Active hemorrhage occurred in 34.7% of cases.. Anticoagulation excess is a common problem in people over 70, where comorbidity and medications may determine the INR value. Bleeding risk is significant so that this group of patients should be closely monitored.

Topics: Acenocoumarol; Aged; Aged, 80 and over; Anticoagulants; Emergency Medical Services; Female; Heart Failure; Hemorrhage; Humans; International Normalized Ratio; Kidney Failure, Chronic; Male; Middle Aged; Prospective Studies

Topics: Acenocoumarol; Aged, 80 and over; Anticoagulants; Antidotes; Calciphylaxis; Female; Humans; Kidney; Kidney Failure, Chronic; Kidney Function Tests; Thiosulfates

Topics: Acenocoumarol; Aged, 80 and over; Anticoagulants; Calciphylaxis; Humans; Kidney Failure, Chronic; Male; Venous Thrombosis

Topics: Acenocoumarol; Edema; Heparin; Heparin, Low-Molecular-Weight; Humans; Immunosuppression Therapy; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Polycystic Kidney, Autosomal Dominant; Polycythemia; Postoperative Complications; Recurrence; Renal Dialysis; Renal Veins; Thrombectomy; Thrombolytic Therapy; Thrombophilia; Thrombophlebitis; Time Factors; Treatment Outcome; Venous Thrombosis