[Atrial fibrillation - what should be taken into account with chronic kidney disease and hemodialysis?]

Deutsche medizinische Wochenschrift (1946) Pub Date : 2024-06-01 Epub Date: 2024-05-23 DOI:10.1055/a-2149-4290
Georg Schlieper
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Abstract

CKD is a common comorbidity in patients with atrial fibrillation. The CHA2DS2-VASc score is not validated in patients with severe CKD and has a low predictive value in dialysis patients. As NOACs are partly eliminated by the kidneys the dosage has to be adapted in CKD. Recent studies indicate an acceptable safety profile for NOACs in CKD. However, larger randomized studies are still lacking. The results from prospective studies with placebo i.e., no anticoagulation therapy, are pending.

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[心房颤动--慢性肾病和血液透析应注意什么?]
慢性肾脏病是心房颤动患者的常见合并症。CHA2DS2-VASc 评分尚未在重度慢性肾脏病患者中得到验证,对透析患者的预测价值较低。由于 NOAC 会被肾脏排出一部分,因此必须调整 CKD 患者的用药剂量。最近的研究表明,NOACs 在 CKD 患者中的安全性是可以接受的。但目前仍缺乏更大规模的随机研究。使用安慰剂(即不进行抗凝治疗)进行的前瞻性研究结果尚未公布。
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