Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Department of Renal Medicine, Liverpool University Hospital, Liverpool, UK.
Cardiovasc Res. 2021 Mar 21;117(4):1046-1059. doi: 10.1093/cvr/cvaa258.
Atrial fibrillation (AF) and chronic kidney disease (CKD) are closely related conditions with shared risk factors. The growing prevalence of both AF and CKD indicates that more patients will suffer from concurrent conditions. There are various complex interlinking mechanisms with important implications for the management of these patients. Furthermore, there is uncertainty regarding the use of oral anticoagulation (OAC) in AF and CKD that is reflected by a lack of consensus between international guidelines. Therefore, the importance of understanding the implications of co-existing AF and CKD should not be underestimated. In this review, we discuss the pathophysiology and association between AF and CKD, including the underlying mechanisms, risk of thrombo-embolic and bleeding complications, influence on stroke management, and evidence surrounding the use of OAC for stroke prevention.
心房颤动（AF）和慢性肾脏病（CKD）是密切相关的疾病，具有共同的危险因素。AF 和 CKD 的患病率不断上升表明，会有更多的患者同时患有这两种疾病。这两种疾病之间存在着各种复杂的相互关联的机制，这些机制对这些患者的管理具有重要意义。此外，在 AF 和 CKD 中使用口服抗凝剂（OAC）的问题上存在不确定性，这反映在国际指南之间缺乏共识。因此，了解同时存在的 AF 和 CKD 的影响的重要性不应被低估。在这篇综述中，我们讨论了 AF 和 CKD 之间的病理生理学和关联，包括潜在的机制、血栓栓塞和出血并发症的风险、对中风管理的影响，以及围绕 OAC 用于预防中风的证据。
