抗凝治疗对心房颤动和慢性肾脏疾病患者肾功能的影响。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Jelena Simic, Miroslav Mihajlovic, Nevena Zec, Vladan Kovacevic, Milan Marinkovic, Nebojsa Mujovic, Tatjana Potpara
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引用次数: 0

摘要

引言:心房颤动(AF)与慢性肾脏疾病(CKD)密切相关。这些疾病有共同的风险因素,并与血栓栓塞事件的风险增加有关。在AF和CKD患者中选择合适的口服抗凝治疗(OAC)具有挑战性。肾功能恶化在接受OACs治疗的AF患者中很常见,尽管并非所有OACs对肾脏的影响都一样。涵盖的领域:在这篇综述中,我们旨在总结目前预防房颤和CKD患者血栓栓塞事件的知识,重点关注特定OAC药物对肾功能的影响。专家意见:对于中风或系统性栓塞风险增加的AF和CKD患者,必须考虑使用OAC。现有证据表明,与维生素K拮抗剂(VKAs)相比,使用非维生素K拮抗药口服抗凝血剂(NOACs)可减缓肾功能恶化。因此,在所有符合NOAC条件的AF和CKD患者中,应优先使用NOAC而不是VKA。对于终末期肾功能不全患者和接受透析或肾脏替代治疗的患者,应根据当地相关的正式建议考虑使用NOAC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of anticoagulation therapy on kidney function in patients with atrial fibrillation and chronic kidney disease.

Introduction: Atrial fibrillation (AF) and chronic kidney disease (CKD) are closely related. These diseases share common risk factors and are associated with increased risk of thromboembolic events. Choosing the appropriate oral anticoagulant therapy (OAC) in patients with AF and CKD is challenging. Deterioration of renal function is common in patients with AF treated with OACs, although not all OACs affect the kidneys equally.

Areas covered: In this review, we aim to summarize the current knowledge of the prevention of thromboembolic events in patients with AF and CKD, focusing on the impact of specific OAC agents on renal function.

Expert opinion: Consideration of OAC use is mandatory in patients with AF and CKD who are at increased risk of stroke or systemic embolism. Available evidence suggests that the use of non-vitamin K antagonist oral anticoagulants (NOACs) is associated with slower deterioration of renal function in comparison to Vitamin K antagonists (VKAs). Hence, a NOAC should be used in preference to VKAs in all NOAC-eligible patients with AF and CKD. Regarding patients with end-stage renal dysfunction and those on dialysis or renal replacement therapy, the use of NOAC should be considered in line with locally relevant formal recommendations.

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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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