Why the study?
A lack of randomized clinical trial data and unvalidated risk assessment scales complicate the choice of anticoagulant therapy in patients with atrial fibrillation on dialysis.
How should anticoagulant therapy be chosen for patients with non-valvular atrial fibrillation on dialysis therapy?
How should anticoagulant therapy be chosen for patients with non-valvular atrial fibrillation on dialysis therapy?
Due to the lack of validated risk scales and RCT data, the choice of anticoagulant therapy in dialysis patients with atrial fibrillation requires a personalized, multidisciplinary approach.
Personalized anticoagulation decisions needed in dialysis AF amid high risks; leaves open RCT-guided strategies and validated risk tools.
The review presents data on the prevalence of atrial fibrillation in patients on dialysis therapy. It is shown that dialysis-dependent patients with non-valve atrial fibrillation prognosis is extremely unfavorable, significantly increased risk of death due to both ischemic and hemorrhagic complications. Scales to assess the risk of thromboembolic and hemorrhagic complications in patients with atrial fibrillation on program dialysis are not validated. The lack of data from randomized clinical trials makes it much more difficult to choose anticoagulant therapy in patients with terminal stage of chronic kidney disease on dialysis who have undergone kidney transplantation. Therefore, the need for anticoagulant therapy and the choice of drugs in patients in this category should be made on the basis of a personalized multidisciplinary approach, taking into account comorbid pathology and the patient's preferences.
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Козиолова et al. (2019) studied this question.
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