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Atrial Fibrillation in Patients with Chronic Kidney Disease

Agnieszka Kotalczyk1, Wern Yew Ding2, Christopher F Wong3

  • 1Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Centre for Heart Diseases, M. Sklodowskiej-Curie 7, Zabrze 41-800, Poland.

Cardiology Clinics
|July 12, 2021
PubMed

Insights

Atrial fibrillation (AF) and chronic kidney disease (CKD) share risks, complicating stroke prevention. An individualized approach is crucial for managing AF patients with CKD, especially those with end-stage renal disease.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Atrial fibrillation (AF) and chronic kidney disease (CKD) share bidirectional relationships and risk factors.
  • Progressive renal dysfunction increases risks of ischemic stroke and bleeding in AF patients.
  • Optimal stroke prevention in AF patients with CKD is challenging.

Purpose of the Study:

  • To discuss an integrated care approach for managing patients with both AF and CKD.
  • To highlight the complexities in stroke prevention strategies for AF patients with declining renal function.

Main Methods:

  • Review of existing literature on the interplay between AF and CKD.
  • Discussion of integrated care models.
  • Analysis of stroke and bleeding risk stratification.

Main Results:

  • Shared risk factors contribute to the bidirectional relationship between AF and CKD.
  • Renal function decline significantly impacts stroke and bleeding risks in AF patients.
  • Current evidence suggests an individualized approach is necessary.

Conclusions:

  • Integrated care is essential for managing AF patients with CKD.
  • Individualized risk stratification for stroke and bleeding is paramount.
  • Further research is needed to clarify optimal stroke prevention in severe CKD and end-stage renal disease.

Keywords:
Atrial fibrillationChronic kidney diseaseEnd-stage renal diseaseOral anticoagulationStroke prevention

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