Delanaye Pierre, Bouquegneau Antoine, Dubois Bernard E, Sprynger Muriel, Mariat Christophe, Krzesinski Jean-Marie, Lancellotti Patrizio
Service de néphrologie-dialyse, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
Service de néphrologie-dialyse, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
Nephrol Ther. 2017 Apr;13(2):59-66. doi: 10.1016/j.nephro.2016.09.002. Epub 2017 Feb 16.
Cardiovascular mortality of hemodialysis patients remains a major problem. The prevalence and incidence of atrial fibrillation in this population are more important than in the general population. The indication of antivitamin K therapy (AVK) in this context of atrial fibrillation must be weighted against the increased risk of bleeding. Unfortunately, and contrary to the general population, an indication of anticoagulation based on embolic or hemorrhagic risk scores is not as clearly established in the hemodialysis population. No prospective randomized study has investigated the benefit/risk balance of anticoagulant treatment in hemodialysis subjects. This article is a review of the current literature on this topic, showing the prevalence of thromboembolic but also bleeding events in the hemodialysis population. The impact of AVK treatment in this specific population is also reviewed. To the best of our knowledge, the indication of treatment must be individualized.
