Rivaroxaban is associated with higher risk of acute kidney disease in patients with non-valvular atrial fibrillation

Introduction: We aimed to investigate the risk of acute kidney disease (AKD) in patients with non-valvular atrial fibrillation (NVAF) who were taking rivaroxaban compared with patients who were not taking rivaroxaban.Methods: A retrospective cohort study was performed using a database to screen out patients with atrial fibrillation who had taken rivaroxaban for 3 months. A total of 793 patients were enrolled in the rivaroxaban group, meanwhile 631 NVAF patients who were not given rivaroxaban with matched age and baseline data were selected as the con-trol group. Characteristics of two groups were compared and the incidence and relative risk of AKD while taking rivaroxaban were analyzed. Results: The incidenc of AKD while taking rivaroxaban was increased compared with those not taking anticoagulation treatment [58/793 Vs. 14/631, relative risk (RR) = 3.297, X-2 = 19.001, P < 0.001]. Multivariate logistic regression analysis correcting confounding factor showed that the risk factors of AKD were independently associated with taking rivaroxaban (OR = 3.441, 95% CI 1.818-6.512, P < 0.001), pre-existing proteinuria (OR = 5.420, 95% CI 3.121-9.415, P < 0.001) in patients with NVAF. Conclusions: We are the first group to verify that taking rivaroxaban is associated with higher risk of acute kidney disease, as well as pre-existing proteinuria com-pared with patients without anticoagulation treatment in patients with NVAF.