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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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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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참고문헌 (65)
참고문헌 신청
United States Renal Data System / 2019 USRDS annual data report: epidemiology of kidney disease in the United States
United States Renal Data System / 2018 USRDS annual data report: Epidemiology of kidney disease in the United States
Buiten MS / 2014 / The dialysis procedure as a trigger for atrial fibrillation : new insights in the development of atrial fibrillation in dialysis patients / Heart 100:685~690
Abuhasira R / 2018 / Atrial fibrillation characteristics in patients on haemodialysis vs. peritoneal dialysis / Sci Rep 8:2976
Olesen JB / 2012 / Stroke and bleeding in atrial fibrillation with chronic kidney disease / N Engl J Med 367:625~635
United States Renal Data System / 2018 USRDS annual data report: Epidemiology of kidney disease in the United States
Buiten MS / 2014 / The dialysis procedure as a trigger for atrial fibrillation : new insights in the development of atrial fibrillation in dialysis patients / Heart 100:685~690
Abuhasira R / 2018 / Atrial fibrillation characteristics in patients on haemodialysis vs. peritoneal dialysis / Sci Rep 8:2976
Olesen JB / 2012 / Stroke and bleeding in atrial fibrillation with chronic kidney disease / N Engl J Med 367:625~635
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