Investigation on Dabigatran Etexilate and Worsening of Renal Function in Patients with Atrial fibrillation: The IDEA Study

Mauro Molteni, Matteo Crippa, Annalisa Orenti, Hernan Polo Friz, Anna Menghini, Pierluigi Tramacere, Giuseppe Marano, Claudio Cimminiello, Patrizia Boracchi

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVES: Warfarin-related nephropathy is an unexplained acute kidney injury, and may occur in patients with supratherapeutic INR, in the absence of overt bleeding. Similar findings have been observed in rats treated with dabigatran etexilate. We conducted a prospective study in dabigatran etexilate-treated patients to assess the incidence of dabigatran-related nephropathy and to investigate the possible correlation between dabigatran plasma concentration (DPC) and worsening renal function.

METHOD: One hundred and seven patients treated long term with dabigatran etexilate for non-valvular atrial fibrillation (NVAF) were followed up for 90 days. DPC, serum creatinine (SCr) and serum cystatin C were prospectively measured. Ninety five patients had complete follow-up data and were evaluable for primary endpoint.

RESULTS: Eleven patients had supratherapeutic DPC, defined as DPC higher than 200 ng/ml at study enrolment, but at the end of follow-up no patient showed a persistent increase in SCr. No patients experienced acute kidney injury.

CONCLUSIONS: Our study shows that no persistent renal detrimental effect is associated with dabigatran treatment. An increase in SCr during dabigatran treatment is reversible and it seems to be unrelated to dabigatran itself.

Original languageEnglish
Pages (from-to)355-362
Number of pages8
JournalClinical Drug Investigation
Volume39
Issue number4
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Aged
  • Aged, 80 and over
  • Antithrombins/pharmacology
  • Atrial Fibrillation/diagnosis
  • Dabigatran/pharmacology
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney/drug effects
  • Kidney Function Tests/trends
  • Male
  • Prospective Studies

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