title: Use of Oral Anticoagulation in the Management of Atrial Fibrillation in Patients with ESRD: Con.
abstract: Among patients with atrial fibrillation, prophylaxis for stroke prevention with the use of anticoagulation is well established in the general population. A number of randomized controlled trials and evidence-based risk prediction tools clearly delineate the benefit and risks of therapy. Despite the high incidence of atrial fibrillation in the late stage CKD and ESRD populations, little high quality evidence exists in these populations. Is it appropriate then to extrapolate findings from the general population to those with CKD/ESRD? In our view, too much uncertainty exists regarding proof of efficacy with clear signals of harm. Routine anticoagulation for stroke prevention in atrial fibrillation is not recommended for the majority of CKD and ESRD patients.
authors: Division of Nephrology, The Ottawa Hospital, Ottawa, Ontario, Canada; and.
authors: Vaibhav
authors: V
authors: Keskar
authors: Division of Nephrology, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors: Manish M
authors: MM
authors: Sood
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D000069604:Dabigatran / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D011720:Pyrazoles / Q000627:therapeutic use; D011728:Pyridones / Q000627:therapeutic use; D018570:Risk Assessment; D000069552:Rivaroxaban / Q000627:therapeutic use; D020521:Stroke / Q000517:prevention & control*; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D014859:Warfarin; D000069552:Rivaroxaban; D000069604:Dabigatran
keywords: Anticoagulation; Blood Coagulation; Chronic; Humans; Incidence; Kidney Failure; Renal Insufficiency; Risk; Uncertainty; atrial fibrillation; chronic kidney disease; hemorrhage; stroke; warfarin