The Quandary of Oral Anticoagulation in Patients with Atrial Fibrillation and Chronic Kidney Disease

Compared to patients with normal renal function, the prevalence of atrial fibrillation (AF) in chronic kidney disease (CKD) is increased, as is consequently the stroke prevalence in these patients. This increased risk of stroke in CKD patients is caused not only by the increased prevalence of AF, but also by associated comorbidities, and inherent platelet and vascular dysfunction. Paradoxically, imbalance in the same factors also increases the bleeding risk, imposing a dilemma as to whether anticoagulation should be prescribed or deferred, particularly in patients with end stage renal disease (ESRD), in whom the bleeding diathesis and thromboembolic predisposition are most recalcitrant.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research