Expósito Víctor, Seras Miguel, Fernández-Fresnedo Gema
Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Cantabria, España.
Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Cantabria, España.
Med Clin (Barc). 2015 May 21;144(10):452-6. doi: 10.1016/j.medcli.2014.03.029. Epub 2014 Jun 2.
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.
心房颤动在慢性肾脏病(CKD)患者中很常见,这会显著增加栓塞风险。CHADS2和HAS - BLED量表用于普通人群评估口服抗凝药(OAC)的风险/获益,但分别低估了CKD患者的栓塞和出血风险,使得难以决定是否使用OAC。基于现有证据,似乎在CKD 3期使用OAC是合适的,而在晚期则存在争议。新型OAC如达比加群和利伐沙班已被批准用于CKD 3期,但它们的作用仍有些不确定。