Anticoagulation, atrial fibrillation, and chronic kidney disease-whose side are you on?
Whether to initiate oral anticoagulant therapy in advanced chronic kidney disease patients with atrial fibrillation remains debatable. Although randomized trial data are lacking, observational studies yield controversial results. Keskar and colleagues analyzed data from a Canadian health care system and found that in elderly chronic kidney disease patients with atrial fibrillation, oral anticoagulant therapy did not prevent ischemic strokes, induced hemorrhages, but prolonged life. These paradoxical findings emphasize the dire need for an adequately powered randomized trial.
Saarland University Medical Center, Saarland University Faculty of Medicine, Internal Medicine IV-Nephrology and Hypertension, Homburg, Germany. Electronic address: gunnar.heine@uks.eu.
Gunnar Henrik
GH
Heine
Department of Cardiology, University Hospital RWTH Aachen, Aachen, Germany.
Vincent
V
Brandenburg
D000925:Anticoagulants; D001281:Atrial Fibrillation; D002170:Canada; D006801:Humans; D051436:Renal Insufficiency, Chronic; D020521:Stroke
D000925:Anticoagulants