Table 2.
Description of real-life studies including chronic kidney disease patients
| Author | Study design | Patients taking DOAC (n) | DOAC type | HR (95% CI) bleeding/stroke (DOAC vs. reference group) | Reference group | Limitations |
|---|---|---|---|---|---|---|
| Lee (2015) [29] | Retrospective G3, G4 patients | 59 |
Rivaroxaban Dabigatran |
0.18 (0.07–0.45)/0.78 (0.21–3.00) | VKA | Small sample size |
| Chan (2015) [34] | Retrospective G5 patients | 525 |
Rivaroxaban Dabigatran |
1.38 (1.03–1.83) (Rivaroxaban); 1.48 (1.21–1.81) (Dabigatran)/na | VKA | Data on stroke not available |
| Harel (2016) [25] | Population-based nested case–control G3, G4 patients | 570 |
Rivaroxaban Dabigatran |
1.22 (0.83–1.79) (Rivaroxaban); 1.15 (0.91–1.45) (Dabigatran)/na | VKA |
Administrative database Data on stroke not available |
| Stanton (2017) [26] | Retrospective G4 patients | 78 | Apixaban | No difference in bleeding and stroke | VKA | Small sample size |
| Sarrat (2017) [33] | Retrospective G5 patients | 40 | Apixaban | No difference in bleeding/na | VKA |
Small sample size Data on stroke not available |
| Becattini (2018) [32] | Prospective G2, G3, G4 patients | 449 |
Dabigatran Rivaroxaban Apixaban |
1.02 (1.01–1.04) every 1 ml/min decrease in eGFR/na | Not worsening renal function | Data on stroke not available |
| Siontis (2018) [35] | Retrospective G5 patients | 2351 | Apixaban |
0.71 (0.56–0.91)/1.11 (0.82–1.50) (2.5 mg bid) 0.71 (0.53–0.95)/0.64 (0.42–0.97) (5 mg bid) |
VKA | Medicare beneficiaries |
| Kumar (2018) [23] | Population-based retrospective G3–G4 patients | 641 |
Rivaroxaban Apixaban Dabigatran Edoxaban (4 patients) |
2.42 (1.44–4.05)/2.60 (2.00–3.38) (DOAC + VKA) | No anticoagulation | Pooled data with VKA |
| Schafer (2018) [31] | Retrospective G4–G5 patients | 302 | Apixaban |
No difference in bleeding and stroke at 0 to 3 months 0.16 (0.05–0.50) at 6–12 months/no difference at 6–12 months |
VKA | Administrative Database |
| Shin (2018) [28] | Retrospective, G3–G4 pts | 1168 |
Dabigatran Rivaroxaban Apixaban |
1.23 (1.02–1.48)/1.02 (0.76–1.37) | VKA | Administrative database |
| Bonnemeier (2019) [27] | Retrospective, CKD patients | 6102 | Rivaroxaban | 0.66 (0.38–1.14)/0.72 (0.55–0.94) | VKA | Administrative database |
| Coleman (2019) [30] | Retrospective, G4–G5 patients | 1896 | Rivaroxaban | − 32% (1–53%)/0.67(0.30–1.50) | VKA | Administrative database |
| Makani (2020) [65] | Retrospective, G3–G4–G5 patients | 10,794 |
Dabigatran Rivaroxaban Apixaban Edoxaban (11 patients) |
G3 0.83 (0.74–0.94)/na G4-G5 0.69 (0.50–0.93)/na |
VKA | Compliance to treatment |
HR hazard ratio, CI confidence interval, VKA vitamin K antagonist