eGFR lower on Apixaban: Worrying a bit... - Atrial Fibrillati...

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eGFR lower on Apixaban

genorm profile image
16 Replies

Worrying a bit here....

Has anyone had a reducing eGFR level on apixaban? I know that this blood test is to see how my kidney function is whilst on apixaban. Before apixaban it was 73, after 4 weeks on it, the eFGR level has dropped to 62. I will be so disappointed if I have to change anti-coagulant, as apixaban seemed appropriate for me and my other health issues. I'm hoping too that we're not looking at CKD! Has anyone had any similar experiences?

Thank you

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genorm
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16 Replies

I don’t believe you need to worry. If kidney function is impaired, the dose of Apixaban is reduced, the drug is not stopped. Apixaban does not cause reduction in kidney function.

The estimated glomerular filtration rate eGFR takes in to account age, sex and the usual kidney test creatinine. A value of 62 is not necessarily significant. It does not indicate automatically any impairment of kidney function. Remember all biochemical tests are subject to variation on serial sampling.

genorm profile image
genorm in reply to

Thank you, oyster. That is good to know. I was feeling quite pleased that I'd had no side effects with apixaban, then the Drs surgery said my test had come back 'borderline'. I have a repeat test in 2 weeks to compare, but I will be ready to talk about reduced dosage to a new GP who prefers phone calls :-(

Tapanac profile image
Tapanac in reply to

Slightly going off Genorm's query (sorry), but my EP is thinking of changing me from Rivaroxaban to Apixaban. Any ideas please as to which anti-coagulant is the best one? Thank you

in reply to Tapanac

Pages 12-14 of this article from 2016 may help (section headed "Starting a specific antithrombotic agent")

ncbi.nlm.nih.gov/pmc/articl...

Beyond criteria which may influence your physician’s choice, it can come down to trying different DOACs if you have side effects,

I have no side effects on Apixaban. I like the twice daily dosing since missing a dose is possibly of less consequence than with the daily DOACs.

When this came up a while ago, Apixaban came out top for frequency of prescription and tolerability I believe. Blood tests for kidney and liver are necessary if on Apixaban to check if a dose reduction is necessary.

Tapanac profile image
Tapanac in reply to

Thank you I'll read the link shortly as the grandchildren have just arrived!!!!!!!! Peace over, eh!

genorm profile image
genorm in reply to

oyster, is it all NOACS that need the kidney/liver blood tests regularly, or just Apixaban? Thanks again.

in reply to genorm

It appears all require at least an annual blood test. Click on each DOAC scenario.

cks.nice.org.uk/anticoagula...

in reply to genorm

This might be helpful for more general DOAC questions.

ncl-mon.nhs.uk/wp-content/u...

Bauldy profile image
Bauldy

Sorry for butting in ... I have been on apixiban for nearly 18 months and have never had a blood test for kidney function is that usual procedure? Not that I have any issues.

in reply to Bauldy

Certainly annually Bauldy, although some say every six months. As oyster says, Apixaban should not adversely affect your kidneys, but it is important to check that their function has not reduced due to other reasons such as ageing.

Bauldy profile image
Bauldy in reply to

Thanks for the reply flapjack , I will speak to my gp next time I can get a appointment probably 2020 😀

bear4ble profile image
bear4ble

If you are not already, suggest you make sure you drink 2 litres of water each day.

genorm profile image
genorm in reply to bear4ble

Thanks. Yes, I am on a mission now; bought a new re-usable bottle and really committed to be fully hydrated.

bear4ble profile image
bear4ble

Don't forget that the main thing about tests is the overall tendency over time. In this case we hope and expect a drop of 5 in a month!! Fingers crossed.

bear4ble profile image
bear4ble

bear4ble here -my age 72-I meant an eGFR rise of 5 points. Apologies!

genorm profile image
genorm

No worries, bear4ble, I knew what you meant! Thanks for the encouragement x

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