Evidence base in Warfarin related nephropathy

1. Warfarin Related Nephropathy: Evidence Based Medicine Wisit Cheungpasitporn, MD. PGY -2, Internal Medicine

9. CONCLUSIONS: Overanticoagulation is associated with faster progression of CKD in a high percentage of patients. Our results indicate the need for prospective trials. Nevertheless, we suggest that our findings are sufficiently compelling at this point to justify extra caution in warfarin -treated CKD patients to avoid overanticoagulation. 37% of CKD pts with elevated INR developed elevated Cr

24. Figure 1 4.44 4.15 4.57 4.13 4.22 4.22 2.75±1.65 1.17±0.71 1.80±1.24 1.13±0.67 P <0.0001 2.45±1.57 1.01±0.49 P <0.0001 1.52±1.08 1.00±0.51 3.25±1.67 1.79±1.09 P <0.0001 2.29±1.33 1.65±0.94

25. Figure 2

26. Figure 3 eGFR calculated by CKD-EPI Creatinine Equation

30. Hematuria and WRN Figure 4

34. Figure 5 73% 58% P<0.001 81.1% 68.9% P= 0.049 P=0.064 3.65, 95% CI 2.81-4.75 Non-significant levels 6months Controlling for covariates; age, CKD, DM, heart falure, GN 3.19, 95% CI 2.45-4.15 Hazard ratio for death

43. AKIN Criteria

46. eGFR calculated by CKD-EPI Creatinine Equation