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Open Access
CC BY 4.0 · TH Open 2022; 06(04): e299-e303
DOI: 10.1055/a-1920-6224
Original Article

Apixaban Prophylactic Anticoagulation in Patients with Nephrotic Syndrome

Authors

  • Tess Van Meerhaeghe 

    1   Department of Nephrology and Dialysis, Hôpital Erasme ULB, Brussels, Belgium

  • Alexandre Cez

    2   Department of Nephrology and Dialysis, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France

  • Karine Dahan

    2   Department of Nephrology and Dialysis, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France

  • Emmanuel Esteve

    2   Department of Nephrology and Dialysis, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France

  • Ismail Elalamy

    3   Hematology and Thrombosis Center, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine, Sorbonne Université, Paris, France
    4   Research Group Cancer, Haemostasis and Angiogenesis, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France
    5   Sorbonne Université, INSERM UMRS1155, Hôpital Tenon, Paris, France
    6   Department of Obstetrics and Gynaecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia

  • Jean Jacques Boffa

    2   Department of Nephrology and Dialysis, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France
    5   Sorbonne Université, INSERM UMRS1155, Hôpital Tenon, Paris, France

  • Eleonore Ponlot

    7   Departement of Nephrology and Dialysis, Grand Hôpital de Charleroi GHDC, Charleroi, Belgium

Funding None.
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Abstract

Background Nephrotic syndrome (NS) is associated with an increased risk of thromboembolic events (TEs), due to hemostatic derangements. The use of direct oral anticoagulants (DOACs) in the prevention of TE has not been studied intensively in patients suffering from NS.

Methods The method included retrospective analysis of consecutive incident patients with NS due to glomerular disease, receiving apixaban for thromboprophylaxis. It is an uncontrolled, single-center study.

Results We identified 27 patients treated with apixaban for the prevention of TEs, in the context of NS. During follow-up, apixaban minimal blood concentration (trough level; Cmin) and maximum blood concentration (Cmax) levels were measured. The mean duration of the anticoagulant treatment was 153 days (±132). Patients were followed for a mean of 14.7 months (±8.4) since the introduction of apixaban. Three patients had a TE at the time of NS diagnosis. Two patients had pulmonary embolism (PE) and one patient presented a stroke in a lupus membranous nephropathy context. One patient developed PE approximately 2 months after the introduction of apixaban treatment. No minor or major bleeding events were noticed.

Conclusion The present study shows that patients, suffering from severe NS under anticoagulant therapy with apixaban had a reduced risk of venous and arterial TEs compared with patients previously described in the literature, without increased risk of bleeding.

Keywords

nephrotic syndrome - anticoagulation - direct oral anticoagulants - thromboembolic event - thromboprophylaxis - hypoalbuminemia

Ethics Approval and Consent to Participate

Approval of ethical committee was not required for this retrospective, and observational study according to Helsinki law and French institutional committee. All patients consented to participate in research studies related to the NS.


Consent for Publication

Not applicable.


Availability of Data and Materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


Authors' Contributions

E.P. created the dataset. T.V.M. completed and statistically analyzed the dataset and drafted the manuscript. J.J.B. and I.E. revised the manuscript. All authors read and approved the final version of the manuscript.




Publication History

Received: 15 December 2021

Accepted: 25 July 2022

Accepted Manuscript online:
08 August 2022

Article published online:
07 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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