Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun;37(3):147-151.
doi: 10.1177/8755122520988728. Epub 2021 Jan 20.

Safety and Efficacy of Apixaban Use in Peritoneal Dialysis: A Review of the Literature

Armaghan Amani  1 , Caitlin M Fellers  2 , Antoinette Eyebe  1 , Alyssa Hall  1 , Meredith L Howard  1
Affiliations
Review

Safety and Efficacy of Apixaban Use in Peritoneal Dialysis: A Review of the Literature

Armaghan Amani et al. J Pharm Technol. 2021 Jun.

Abstract

Objective: To review the safety and efficacy of apixaban for the treatment of nonvalvular atrial fibrillation or venous thromboembolism in patients receiving peritoneal dialysis (PD). Data Sources: A PubMed and MEDLINE search was conducted through December 2020 using the following keywords and Medical Subject Headings (MeSH) terms alone or in various combinations: apixaban, peritoneal dialysis, continuous ambulatory peritoneal dialysis, end-stage renal disease, and hemodialysis. Study Selection and Data Extraction: English-language studies evaluating clinical outcomes pertaining to the use of apixaban in end stage renal disease (ESRD), which included patients receiving peritoneal dialysis were eligible for inclusion. Data Synthesis: Four studies were identified that met inclusion for this review, all retrospective in nature. These studies compared the safety and efficacy of apixaban with standard therapy in ESRD included patients on dialysis, with a very limited number of subjects receiving PD. In these studies, apixaban was shown to be potentially safer and more effective than warfarin. Outcomes did not differentiate between patients receiving PD or not. Conclusions: Use of apixaban in patients receiving PD may be safe and effective based on data from limited patients. Pharmacokinetics and pharmacodynamics of apixaban in the PD setting is an important question that clinicians should consider with use of this medication in the ESRD population. More studies focusing on the PD population are needed to better assess the use of apixaban in this understudied population.

Keywords: DOACs; apixaban; end-stage renal disease; hemodialysis; peritoneal dialysis.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of publication inclusion.
See this image and copyright information in PMC

References

    1. National Institute of Diabetes and Digestive and Kidney Diseases. Peritoneal dialysis. Accessed December 29, 2020. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failu...
    1. Jain AK, Blake P, Cordy P, Garg AX. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol. 2012;23:533-544. doi:10.1681/ASN.2011060607 - DOI - PMC - PubMed
    1. Pratsinis A, Devuyst O, Leroux JC. Peritoneal dialysis beyond kidney failure? J Control Release. 2018;282:3-12. doi:10.1016/j.jconrel.2018.01.017 - DOI - PubMed
    1. Jameson MD, Wiegmann TB. Principles, uses and complications of hemodialysis. Med Clin North Am. 1990;74:945-960. doi:10.1016/s0025-7125(16)30528-4 - DOI - PubMed
    1. January CT, Wann S, Calkins H, et al.. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines and the Heart Rhythm Society. Circulation. 2019;140:e125-e151. doi:10.1161/CIR.0000000000000665 - DOI - PubMed