Key result
NOAC efficacy and safety data remains scarce for AF in CKD and ESRD.
This review highlights the substantial clinical impact of atrial fibrillation in patients with advanced kidney disease and emphasizes the critical need for more research on the safety and efficacy of novel oral anticoagulants in this population.
AF in advanced CKD/ESRD lacks robust NOAC data, urging clinical caution; leaves open key efficacy and safety questions for dedicated trials.
PURPOSE OF REVIEW: Atrial fibrillation is the most common sustained arrhythmia in patients with kidney disease. The purpose of this review is to describe the burden of atrial fibrillation in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), postulate possible mechanisms to explain this burden of disease, understand the clinical consequences of atrial fibrillation and review the treatment options for atrial fibrillation specific to patients with kidney disease. RECENT FINDINGS: Recent literature has revealed that the clinical multiorgan impact of atrial fibrillation in patients with CKD and ESRD is substantial. Although novel oral anticoagulants to treat atrial fibrillation and prevent associated complications have been tested in large trials in the general population, there is a paucity of data on the efficacy and safety of these agents in patients with advanced CKD and ESRD. SUMMARY: Atrial fibrillation is a significant comorbidity in patients with CKD and ESRD with important prognostic implications. More research is needed to understand the mechanisms that contribute to the disproportionate burden of this arrhythmia in patients with kidney disease and in to treatment options specific to this population of high-risk patients.
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Bansal et al. (2014) conducted a review in Atrial fibrillation in chronic kidney disease and end-stage renal disease. Atrial fibrillation is a significant comorbidity in patients with chronic kidney disease and end-stage renal disease, but there is a paucity of data on the efficacy and safety of novel oral anticoagulants in this population.
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