title: [Atrial fibrillation and anticoagulation in hemodialysis patients: A complex decision].
abstract: Cardiovascular mortality of hemodialysis patients remains a major problem. The prevalence and incidence of atrial fibrillation in this population are more important than in the general population. The indication of antivitamin K therapy (AVK) in this context of atrial fibrillation must be weighted against the increased risk of bleeding. Unfortunately, and contrary to the general population, an indication of anticoagulation based on embolic or hemorrhagic risk scores is not as clearly established in the hemodialysis population. No prospective randomized study has investigated the benefit/risk balance of anticoagulant treatment in hemodialysis subjects. This article is a review of the current literature on this topic, showing the prevalence of thromboembolic but also bleeding events in the hemodialysis population. The impact of AVK treatment in this specific population is also reviewed. To the best of our knowledge, the indication of treatment must be individualized.
authors.affiliation: Service de néphrologie-dialyse, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique. Electronic address: pierre_delanaye@yahoo.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Delanaye
authors.affiliation: Service de néphrologie-dialyse, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
authors.forename: Antoine
authors.initials: A
authors.lastname: Bouquegneau
authors.affiliation: Service de néphrologie-dialyse, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Dubois
authors.affiliation: Service de cardiologie, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
authors.forename: Muriel
authors.initials: M
authors.lastname: Sprynger
authors.affiliation: Service de néphrologie, dialyse et transplantation, CHU de Saint-Étienne, université Jean-Monnet, 42055 Saint-Étienne, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariat
authors.affiliation: Service de néphrologie-dialyse, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Krzesinski
authors.affiliation: Service de cardiologie, CHU Sart Tilman, université de Liège, 4000 Liège, Belgique.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D006435:Renal Dialysis; D020521:Stroke / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Anticoagulation; Atrial fibrillation; Bleeding risk; Fibrillation auriculaire; Hemodialysis; Hémodialyse; Risque hémorragique