Systemic anticoagulation in progressive chronic kidney disease and atrial fibrillation.

ObjectivePatients with chronic kidney disease are at high risk of developing atrial fibrillation. However, it remains unclear whether systemic anticoagulants should be utilized, particularly in the later stages of chronic kidney disease.MethodsThis retrospective observational cohort study included patients with chronic kidney disease of various etiologies. This study aimed to record the prevalence of atrial fibrillation, use of systemic anticoagulation, and incidence of thromboembolic events and bleeding events among these patients.ResultsA total of 146 patients with chronic kidney disease were included in this study, with 43.8% of them experiencing atrial fibrillation. There was no significant difference in the prevalence of atrial fibrillation across various stages of chronic kidney disease. Thromboembolic events were not common in patients with atrial fibrillation but were prevalent in those with late-stage chronic kidney disease. Furthermore, patients with atrial fibrillation experienced a higher frequency of bleeding events, with the highest incidence observed in chronic kidney disease stage IV.ConclusionsAs systemic anticoagulation did not lower the frequency of thromboembolic events in patients with chronic kidney disease and atrial fibrillation in our study and considering that these patients experienced a higher frequency of bleeding complications, the use of systemic anticoagulants should be approached with caution, particularly in the later stages of chronic kidney disease.