CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY)
Assessment of kidney function is mandatory in all cardiac patients, and patients with atrial fibrillation represent a category of patients with high thrombotic risk, which increases the risk of decreased kidney function during follow-up. Controversial issues of warfarin-associated nephropathy are im...
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«REMEDIUM GROUP» Ltd.
2018-05-01
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| Series: | Атеротромбоз |
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| Online Access: | https://www.aterotromboz.ru/jour/article/view/156 |
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| author | E. S. Kropacheva O. A. Zemlyanskaya A. В. Dobrovolsky Е. P. Panchenko |
| author_facet | E. S. Kropacheva O. A. Zemlyanskaya A. В. Dobrovolsky Е. P. Panchenko |
| author_sort | E. S. Kropacheva |
| collection | DOAJ |
| description | Assessment of kidney function is mandatory in all cardiac patients, and patients with atrial fibrillation represent a category of patients with high thrombotic risk, which increases the risk of decreased kidney function during follow-up. Controversial issues of warfarin-associated nephropathy are important today. A prospective 5-year follow-up of 172 patients receiving warfarin therapy showed that 26.7% had the sudden loss of renal function (SLRF) (defined as an annual decline in glomerular filtration rate (GFR) ≥ 3 ml/min/1.73 cm2). Based on the results of the ROC analysis, it was determined that the maximum INR > 3.97 was associated with the SLRF (the area under the curve was 0.649, the sensitivity 56.5%, the specificity 74.6%, p = 0.003), and the maximum INR> 6.0 increased the specificity of the analysis to 96%. The study showed that for patients who had a maximum INR value ≥ 3.97, the mean delta of changes in GFR was negative, and the largest negative dynamics was characteristic for patients with a maximum INR ≥ 6.0. The estimated odd ratio of SLRF confirms the high prognostic significance of the maximum INR value. The maximum INR 3.97-5.9 increased the risk of SLRF by 3.07 times (95% CI 1.5241-6.2017, p = 0.0017), as well as the INR ≥ 6.0 (OR 3.05, 95% CI 1.0073-9.2433, p = 0.0485). The multifactorial discriminant analysis showed that the SLRF predictors against the background of 5-year warfarin therapy included the maximum INR ≥ 3.97 (F = 10.45, p = 0.0014), IHD (F = 8.7, p = 0.0036), diabetic nephropathy (F = 5.29, p = 0.0226) and the CHA2DS2-VASc score ≥ 4 (F = 5.05, p = 0.0258). |
| format | Article |
| id | doaj-art-49902e4a8bea41b4869478bf7aa7d38b |
| institution | DOAJ |
| issn | 2307-1109 2658-5952 |
| language | Russian |
| publishDate | 2018-05-01 |
| publisher | «REMEDIUM GROUP» Ltd. |
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| series | Атеротромбоз |
| spelling | doaj-art-49902e4a8bea41b4869478bf7aa7d38b2025-08-20T03:05:33Zrus«REMEDIUM GROUP» Ltd.Атеротромбоз2307-11092658-59522018-05-010110712110.21518/2307-1109-2018-1-107-121138CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY)E. S. Kropacheva0O. A. Zemlyanskaya1A. В. Dobrovolsky2Е. P. Panchenko3A.L.Myasnikov Clinical Cardiology Institute, Federal State Budget Organization «National Medical Research Centre of Cardiology» of the Ministry of Health of the Russian FederationA.L.Myasnikov Clinical Cardiology Institute, Federal State Budget Organization «National Medical Research Centre of Cardiology» of the Ministry of Health of the Russian FederationA.L.Myasnikov Clinical Cardiology Institute, Federal State Budget Organization «National Medical Research Centre of Cardiology» of the Ministry of Health of the Russian FederationA.L.Myasnikov Clinical Cardiology Institute, Federal State Budget Organization «National Medical Research Centre of Cardiology» of the Ministry of Health of the Russian FederationAssessment of kidney function is mandatory in all cardiac patients, and patients with atrial fibrillation represent a category of patients with high thrombotic risk, which increases the risk of decreased kidney function during follow-up. Controversial issues of warfarin-associated nephropathy are important today. A prospective 5-year follow-up of 172 patients receiving warfarin therapy showed that 26.7% had the sudden loss of renal function (SLRF) (defined as an annual decline in glomerular filtration rate (GFR) ≥ 3 ml/min/1.73 cm2). Based on the results of the ROC analysis, it was determined that the maximum INR > 3.97 was associated with the SLRF (the area under the curve was 0.649, the sensitivity 56.5%, the specificity 74.6%, p = 0.003), and the maximum INR> 6.0 increased the specificity of the analysis to 96%. The study showed that for patients who had a maximum INR value ≥ 3.97, the mean delta of changes in GFR was negative, and the largest negative dynamics was characteristic for patients with a maximum INR ≥ 6.0. The estimated odd ratio of SLRF confirms the high prognostic significance of the maximum INR value. The maximum INR 3.97-5.9 increased the risk of SLRF by 3.07 times (95% CI 1.5241-6.2017, p = 0.0017), as well as the INR ≥ 6.0 (OR 3.05, 95% CI 1.0073-9.2433, p = 0.0485). The multifactorial discriminant analysis showed that the SLRF predictors against the background of 5-year warfarin therapy included the maximum INR ≥ 3.97 (F = 10.45, p = 0.0014), IHD (F = 8.7, p = 0.0036), diabetic nephropathy (F = 5.29, p = 0.0226) and the CHA2DS2-VASc score ≥ 4 (F = 5.05, p = 0.0258).https://www.aterotromboz.ru/jour/article/view/156warfarinnephropathysudden loss of renal function |
| spellingShingle | E. S. Kropacheva O. A. Zemlyanskaya A. В. Dobrovolsky Е. P. Panchenko CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY) Атеротромбоз warfarin nephropathy sudden loss of renal function |
| title | CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY) |
| title_full | CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY) |
| title_fullStr | CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY) |
| title_full_unstemmed | CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY) |
| title_short | CLINICAL FACTORS AND ANTICOAGULATION LEVEL THAT DETERMINE THE SUDDEN LOSS OF KIDNEY FUNCTION IN PATIENTS LONG-TAKING WARFARIN (A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY) |
| title_sort | clinical factors and anticoagulation level that determine the sudden loss of kidney function in patients long taking warfarin a 5 year prospective observational study |
| topic | warfarin nephropathy sudden loss of renal function |
| url | https://www.aterotromboz.ru/jour/article/view/156 |
| work_keys_str_mv | AT eskropacheva clinicalfactorsandanticoagulationlevelthatdeterminethesuddenlossofkidneyfunctioninpatientslongtakingwarfarina5yearprospectiveobservationalstudy AT oazemlyanskaya clinicalfactorsandanticoagulationlevelthatdeterminethesuddenlossofkidneyfunctioninpatientslongtakingwarfarina5yearprospectiveobservationalstudy AT avdobrovolsky clinicalfactorsandanticoagulationlevelthatdeterminethesuddenlossofkidneyfunctioninpatientslongtakingwarfarina5yearprospectiveobservationalstudy AT eppanchenko clinicalfactorsandanticoagulationlevelthatdeterminethesuddenlossofkidneyfunctioninpatientslongtakingwarfarina5yearprospectiveobservationalstudy |