Why the study?
Anticoagulant-related nephropathy has been documented with both warfarin and direct oral anticoagulants, prompting an evaluation of the comparative effect of DOACs versus VKAs on renal function deterioration in atrial fibrillation.
Do direct oral anticoagulants (DOACs) reduce the risk of renal function deterioration compared to Vitamin K antagonists (VKAs) in patients with atrial fibrillation?
Population
302,071 AF patients across 13 studies
Comparison
DOACs vs VKAs
Design
Systematic review and meta-analysis
Follow-up
Mean 2.3 years per patient
Key result
Direct oral anticoagulants were associated with a lower risk of 30% eGFR reduction compared to Vitamin K antagonists in patients with atrial fibrillation (HR 0.72; 95% CI 0.59-0.88).
Authors
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Supports DOAC preference over VKAs in AF to lower renal decline risk; extends meta-analytic data on kidney outcomes.
Meta-Analysis (n=302,071)
Do direct oral anticoagulants (DOACs) reduce the risk of renal function deterioration compared to Vitamin K antagonists (VKAs) in patients with atrial fibrillation?
Hazard Ratio: 0.72 (95% CI 0.59–0.88)
In patients with atrial fibrillation, the use of DOACs is associated with a significantly delayed deterioration of renal function compared to vitamin K antagonists.
Αναστασία Θ. Αδάμου (2026) conducted a meta-analysis in Atrial fibrillation (n=302,071). Direct Oral Anticoagulants (DOACs) vs. Vitamin K antagonists (VKAs) was evaluated on 30% estimated glomerular filtration rate (eGFR) decline (HR 0.72, 95% CI 0.59-0.88). Direct oral anticoagulants were associated with a lower risk of 30% eGFR reduction compared to Vitamin K antagonists in patients with atrial fibrillation (HR 0.72; 95% CI 0.59-0.88).