Associations of acute kidney injury with oral anticoagulants: a disproportionality analysis of the food and drug administration adverse event reporting system (FAERS) database

The FDA Adverse Event Reporting System (FAERS) was used to evaluate the associations between oral anticoagulants (OACs) and acute kidney injury (AKI). Disproportionality analysis were applied to data in the FAERS database from January 2004 to December 2023 to detect adverse events (AEs) for various OACs. The adjusted reporting odds ratios (RORs) calculated using multiple logistic regression were used to explore the risk factors for OACs-associated AKI. The median age of patients with reported OACs-associated AKI was 76 years (interquartile range = 68-83 years), with 53.82% of the reports being for males. The crude RORs for the associations of AKI with warfarin, rivaroxaban, dabigatran, apixaban and edoxaban were 1.35, 2.14, 2.98, 1.33 and 3.56, respectively. The risk of OACs-associated AKI was affected by age and sex, being higher in those aged 65 years and males. The adjusted RORs for rivaroxaban, dabigatran, apixaban and edoxaban were 1.26, 1.67, 0.65 and 2.06, respectively. After adjusting for factors confounding the interactions between age, sex and the administered medication, all five OACs had different risk factors for AKI. Nearly 50% of AKI cases occurred within the first 2 months, and each OAC was of the early-failure type. Hospitalization and mortality rates for AKI patients after OACs were 45.53% and 22.98%, respectively. The study highlights the strong association between AKI and OACs, emphasizing the need for regular renal function monitoring from the initial stages of OACs, especially in elderly male patients. Further in-depth research is needed to confirm these findings.