Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000100057 |
Resumo: | ABSTRACT Atrial fibrillation is highly prevalent in patients with end‑stage kidney disease. For patients with atrial fibrillation but normal kidney function, the net clinical benefit of oral anticoagulation with vitamin K antagonists and non‑vitamin K oral anticoagulants in preventing stroke against the hemorrhagic risk is well‑known. However, dialysis patients present unique risk factors that increase ischemic stroke and bleeding events that are not included in the traditional risk scores. These points, in addition to the pharmacokinetic issues related to the use of oral anticoagulants in end‑stage kidney disease, raise the question of the safety of these drugs, making it difficult to predict whether the benefit outweighs the risk. Data on this topic in chronic kidney disease stages 4, 5, and 5D patients is sparse and the clinical guidelines are also inconsistente in which is the best approach for these patients. This review gives an overview of the state of the art on this topic, specifically the recommendations of the newest guidelines, then discusses the various risk scores and their pitfalls, and finally summarizes the current knowledge on the possible benefits of Non‑vitamin K oral anticoagulants versus Vitamin K antagonists in dialysis patients. |
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Oral anticoagulation in patients with atrial fibrillation and end-stage kidney diseaseAtrial fibrillationchronic kidney diseasedialysisend‑stage kidney diseasenon‑vitamin K oral anticoagulantsvitamin K antagonistsABSTRACT Atrial fibrillation is highly prevalent in patients with end‑stage kidney disease. For patients with atrial fibrillation but normal kidney function, the net clinical benefit of oral anticoagulation with vitamin K antagonists and non‑vitamin K oral anticoagulants in preventing stroke against the hemorrhagic risk is well‑known. However, dialysis patients present unique risk factors that increase ischemic stroke and bleeding events that are not included in the traditional risk scores. These points, in addition to the pharmacokinetic issues related to the use of oral anticoagulants in end‑stage kidney disease, raise the question of the safety of these drugs, making it difficult to predict whether the benefit outweighs the risk. Data on this topic in chronic kidney disease stages 4, 5, and 5D patients is sparse and the clinical guidelines are also inconsistente in which is the best approach for these patients. This review gives an overview of the state of the art on this topic, specifically the recommendations of the newest guidelines, then discusses the various risk scores and their pitfalls, and finally summarizes the current knowledge on the possible benefits of Non‑vitamin K oral anticoagulants versus Vitamin K antagonists in dialysis patients.Sociedade Portuguesa de Nefrologia2022-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000100057Portuguese Journal of Nephrology & Hypertension v.36 n.1 2022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000100057Azevedo,Tânia B.Correia,Sofiainfo:eu-repo/semantics/openAccess2024-02-06T17:05:13Zoai:scielo:S0872-01692022000100057Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:19:07.509189Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
title |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
spellingShingle |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease Azevedo,Tânia B. Atrial fibrillation chronic kidney disease dialysis end‑stage kidney disease non‑vitamin K oral anticoagulants vitamin K antagonists |
title_short |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
title_full |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
title_fullStr |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
title_full_unstemmed |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
title_sort |
Oral anticoagulation in patients with atrial fibrillation and end-stage kidney disease |
author |
Azevedo,Tânia B. |
author_facet |
Azevedo,Tânia B. Correia,Sofia |
author_role |
author |
author2 |
Correia,Sofia |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Azevedo,Tânia B. Correia,Sofia |
dc.subject.por.fl_str_mv |
Atrial fibrillation chronic kidney disease dialysis end‑stage kidney disease non‑vitamin K oral anticoagulants vitamin K antagonists |
topic |
Atrial fibrillation chronic kidney disease dialysis end‑stage kidney disease non‑vitamin K oral anticoagulants vitamin K antagonists |
description |
ABSTRACT Atrial fibrillation is highly prevalent in patients with end‑stage kidney disease. For patients with atrial fibrillation but normal kidney function, the net clinical benefit of oral anticoagulation with vitamin K antagonists and non‑vitamin K oral anticoagulants in preventing stroke against the hemorrhagic risk is well‑known. However, dialysis patients present unique risk factors that increase ischemic stroke and bleeding events that are not included in the traditional risk scores. These points, in addition to the pharmacokinetic issues related to the use of oral anticoagulants in end‑stage kidney disease, raise the question of the safety of these drugs, making it difficult to predict whether the benefit outweighs the risk. Data on this topic in chronic kidney disease stages 4, 5, and 5D patients is sparse and the clinical guidelines are also inconsistente in which is the best approach for these patients. This review gives an overview of the state of the art on this topic, specifically the recommendations of the newest guidelines, then discusses the various risk scores and their pitfalls, and finally summarizes the current knowledge on the possible benefits of Non‑vitamin K oral anticoagulants versus Vitamin K antagonists in dialysis patients. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-03-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000100057 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000100057 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692022000100057 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
dc.source.none.fl_str_mv |
Portuguese Journal of Nephrology & Hypertension v.36 n.1 2022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799137280832569344 |