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International Urology and Nephrology
Published in: International Urology and Nephrology 9/2018

01-09-2018 | Nephrology - Review

Atrial fibrillation in dialysis patients: is there a place for non-vitamin K antagonist oral anticoagulants?

Authors: Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk

Published in: International Urology and Nephrology | Issue 9/2018

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Abstract

Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin. Nevertheless according to ESC guidelines, NOACs are not recommended in patients with creatinine clearance < 30 mL/min. Observational studies provide contradictive data. Only few new trials are ongoing. Therefore, it is not clear if NOACs should be in the future prescribed to patients with advanced CKD and those on dialysis. Moreover, the risk of stroke and bleeding is much higher in such population than in patients without end-stage renal disease (ESRD). The authors provide data on pros and cons of use of NOACs in ESRD patients with AF.
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Metadata
Title
Atrial fibrillation in dialysis patients: is there a place for non-vitamin K antagonist oral anticoagulants?
Authors
Elzbieta Mlodawska
Paulina Lopatowska
Jolanta Malyszko
Maciej Banach
Bożena Sobkowicz
Adrian Covic
Anna Tomaszuk-Kazberuk
Publication date
01-09-2018
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 9/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-018-1877-y

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