[Treatment of atrial fibrillation in dialyzed patients: the role of oral anticoagulants. The nephrologist's point of view]

Abstract

Atrial fibrillation is the most frequent arrhythmia in patients on dialysis. Whereas it is associated with a higher thromboembolic risk in the general population, this association has not been unequivocally confirmed in dialysis patients. Furthermore, the potential benefits of oral anticoagulant therapy in uremia have been recently reviewed, given the increased risk of bleeding in these patients. Cardiologic guidelines to guide the choice of oral anticoagulant therapy by stratifying the thromboembolic and hemorrhagic risks were developed in the general population and their generalization to dialysis patients has not been validated. This paper will discuss the association between atrial fibrillation and thromboembolic risk in dialysis, presenting some strategies to evaluate the risk-benefit balance of oral anticoagulant therapy in dialysis patients affected by atrial fibrillation.