AI Article Synopsis
- Atrial fibrillation is prevalent in chronic kidney disease (CKD) patients, significantly raising the risk of embolism.
- The CHADS2 and HAS-BLED risk assessment scales are not fully reliable for CKD patients, complicating decisions about using oral anticoagulation (OAC).
- Current evidence suggests that OAC is advisable for patients in stage 3 CKD, but its use becomes controversial in more advanced stages; newer OACs like dabigatran and rivaroxaban are approved for stage 3, yet their effectiveness remains unclear.
Article Abstract
Atrial fibrillation is a common finding in patients with chronic kidney disease (CKD), which increases markedly the embolism risk. The CHADS2 and HAS-BLED scales, used in the general population to assess the risk/benefit of oral anticoagulation (OAC), underestimate respectively the risk of embolism and haemorrhage in CKD, making it difficult to decide whether to use OAC or not. Based on the available evidence, it seems indicated to use OAC in stage 3 CKD, while it is controversial in advanced stages. New OAC such as dabigatran and rivaroxaban have been approved in stage 3 CKD but their role is still somewhat uncertain.
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| http://dx.doi.org/10.1016/j.medcli.2014.03.029 | DOI Listing |
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