Renal Disease and Atrial Fibrillation

Card Electrophysiol Clin. 2021 Mar;13(1):95-112. doi: 10.1016/j.ccep.2020.11.001. Epub 2021 Jan 8.

Abstract

Incidence and prevalence of atrial fibrillation (AF) and chronic kidney disease are increasing, and the two conditions commonly coexist. Renal impairment further increases the risk of ischemic stroke and systemic thromboembolism in patients with AF but also paradoxically predisposes to bleeding. Renal function should be monitored closely in patients with AF requiring oral anticoagulation therapy, particularly those receiving direct oral anticoagulants. Vitamin K antagonists can be used as part of a dose-adjusted anticoagulation regimen in patients with mild to moderate renal dysfunction. Dialysis-dependent patients taking vitamin K antagonists are at increased risk of sustaining major hemorrhage.

Keywords: Atrial fibrillation; Chronic kidney disease; Management; Risk stratification.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation*
  • Humans
  • Renal Insufficiency, Chronic*
  • Risk Factors