Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines.

Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines. Pol Arch Med Wewn. 2016 May 31;126(5):353-62 Authors: Młodawska E, Tomaszuk-Kazberuk A, Łopatowska P, Musiał WJ, Małyszko J Abstract Atrial fibrillation (AF) frequently occurs in patients with chronic kidney disease (CKD), and the rate reaches even 30% in patients with end-stage renal disease (ESRD). Patients with AF and CKD have a significantly higher risk of thrombotic complications, particularly ischemic stroke, and at the same time, a higher bleeding risk (proportionally to the grade of renal failure). In addition, AF and CKD share a number of comorbidities and risk factors, which results in increased mortality rates. Moreover, disturbances in hemostasis are common complications of kidney disease. Their occurrence and severity correlate with worsening renal function, including ESRD. At present, the incidence of bleeding is declining, while thrombotic complications have become the predominant cause of mortality. Prophylactic antithrombotic treatment reduces the rate of stroke and other thrombotic complications. Vitamin K antagonists (VKAs) have long been used in anticoagulant therapy, and more recently, non-vitamin K oral anticoagulants (NOACs) have been introduced, which are direct thrombin inhibitors. NOACs are a valuable anticoagulant option in this group of patients as long as a summary of product characteristics i...
Source: Polskie Archiwum Medycyny Wewnetrznej - Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research