Is it safe to use Eprex along with Warfarin in CKD patients?

Question

Hi doctor,

I am a CKD patient in stage 4 with a creatinine level of 6 mg/dl and a urea level of 109 mg/dl. My hemoglobin level is 10 gm/dl. I know I am not indicated to use Eprex (Epoetin alfa). Still, I am responsible for using it to enhance the quality of life, to prevent stroke and other coagulant problems that may occur with Eprex. Can I combinate it with an anticoagulant (Warfarin)?

Answer 1

Hi,

Welcome to icliniq.com.

I read your query. Based on your investigations and history, you have CKD (chronic kidney disease) stage 5. Since your hemoglobin is 10 gm/dl, you do not need Eprex, but you will need that soon. So keep monitoring your hemoglobin.

Regarding the use of Warfarin, I would not recommend that. Warfarin use for the prevention of stroke is not recommended in CKD (chronic kidney disease), as it is not beneficial in CKD (chronic kidney disease), and it increases bleeding risk.

I would recommend you to :

1. Get an AV (arteriovenous) fistula created, as you will need dialysis soon.

2. If possible, get yourself enrolled for a transplant.

3. Keep the rest of the treatment as it is. Avoid any nephrotoxic drugs.

Keep monitoring your KFT (kidney function test), hemoglobin, calcium, phosphorus, uric acid, PTH (parathyroid hormone), and vitamin D levels.

If possible, you can send me your full reports, and I would be happy to help you.