scholarly journals Treatment of atrial fibrillation with warfarin among older adults with end stage renal disease

2017 ◽  
Vol 30 (6) ◽  
pp. 831-839 ◽  
Author(s):  
Jingwen Tan ◽  
Sunjae Bae ◽  
Jodi B. Segal ◽  
Junya Zhu ◽  
Dorry L. Segev ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

Non-vitamin-K-dependent Oral Anticoagulants in End-stage Renal Disease Patients with Non-valvular Atrial Fibrillation: An Impossible Wedding?

2017 ◽  
Vol 29 (2) ◽  
pp. 117-126
Author(s):  
Luca Di Lullo ◽  
Fulvio Floccari ◽  
Rodolfo Rivera ◽  
Vincenzo Barbera ◽  
Antonio Bellasi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Renal Disease ◽  
Vitamin K ◽  
End Stage Renal Disease ◽  
Oral Anticoagulants ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Anticoagulation in Patients with End-Stage Renal Disease and Atrial Fibrillation: Confusion, Concerns and Consequences

2020 ◽  
Vol 22 (3) ◽  
pp. 306-316
Author(s):  
Narender Goel ◽  
Deepika Jain ◽  
Danny B. Haddad ◽  
Divya Shanbhogue
Keyword(s):  
Atrial Fibrillation ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Decision Making ◽  
Controlled Trial ◽  
Oral Anticoagulants ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End-stage renal disease (ESRD) patients have a higher prevalence of diabetes mellitus, hypertension, congestive heart failure and advanced age, along with an increased incidence of non-valvular atrial fibrillation (AF), thereby increasing the risk for cerebrovascular accidents. Systemic anticoagulation is therefore recommended in patients with ESRD with AF to reduce the risk and complications from thromboembolism. Paradoxically, these patients are at an increased risk of bleeding due to great degree of platelet dysfunction and impaired interaction between platelet and endothelium. Currently, CHA2DS2-VASc and Hypertension, Abnormal liver/kidney function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol (HAS-BLED) are the recommended models for stroke risk stratification and bleeding risk assessment in patients with AF. There is conflicting data regarding benefits and risks of medications such as antiplatelet agents, warfarin and direct oral anticoagulants in ESRD patients with AF. Moreover, there is no randomized controlled trial data to guide the clinical decision making. Hence, a multi-disciplinary approach with annual re-evaluation of treatment goals and risk-benefit assessment has been recommended. In this article, we review the current recommendations with risks and benefits of anticoagulation in patients with ESRD with AF.

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