Oral anticoagulation in chronic kidney disease with atrial fibrillation

Atrial fibrillation is a common finding in patients with chronic kidney disease (CKD), which increases markedly the embolism risk. The CHADS2 and HAS-BLED scales, used in the general population to assess the risk/benefit of oral anticoagulation (OAC), underestimate respectively the risk of embolism...

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Bibliographic Details
Published inMedicina clinica Vol. 144; no. 10; p. 452
Main Authors Expósito, Víctor, Seras, Miguel, Fernández-Fresnedo, Gema
Format Journal Article
LanguageSpanish
Published Spain 21.05.2015
Subjects
Administration, Oral
Anticoagulants - therapeutic use
Atrial Fibrillation - complications
Dabigatran - therapeutic use
Embolism - etiology
Embolism - prevention & control
Hemorrhage - chemically induced
Hemorrhage - prevention & control
Humans
Renal Insufficiency, Chronic - complications
Risk Assessment
Risk Factors
Rivaroxaban - therapeutic use
Stroke - etiology
Stroke - prevention & control
Oral anticoagulation
Stroke
Atrial fibrillation
Hemodiálisis
Chronic kidney disease
Fibrilación auricular
Haemodialysis
Ictus
Anticoagulación oral
Enfermedad renal crónica
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Summary:Atrial fibrillation is a common finding in patients with chronic kidney disease (CKD), which increases markedly the embolism risk. The CHADS2 and HAS-BLED scales, used in the general population to assess the risk/benefit of oral anticoagulation (OAC), underestimate respectively the risk of embolism and haemorrhage in CKD, making it difficult to decide whether to use OAC or not. Based on the available evidence, it seems indicated to use OAC in stage 3 CKD, while it is controversial in advanced stages. New OAC such as dabigatran and rivaroxaban have been approved in stage 3 CKD but their role is still somewhat uncertain.
ISSN:1578-8989
DOI:10.1016/j.medcli.2014.03.029