Non-valvular atrial fibrillation in patients on peritoneal dialysis: prevalence, treatment and professionals involved

Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillar for the prevention of thromboembolic events. However, there are no randomiz...

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Detalles Bibliográficos
Autores: Perez-Bernat, ME, Vinas, A, Vera, M, Gonzalez-Rico, M, Montomoli, M, Astudillo-Cortes, E, Quevedo-Reina, JC, Garcia-Mendez, I, Martinez-Losa, A, Rama-Arias, I, Maldonado-Martin, MM, Munar, MA, Ortega-Cerrato, A, Beltran-Catalan, S, del Peso, G, Cases, A, Corriz, JL
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p18540
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/18540
Access Level:acceso abierto
Palabra clave:Peritoneal dialysis
Atrial fibrillation
Oral anticoagulation
Antiplatelet agents
Direct oral anticoagulants
Vitamin K antagonists
Descripción
Sumario:Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillar for the prevention of thromboembolic events. However, there are no randomized clinical trials on the risk -benefit profile of oral anticoagulation in patients with chronic kidney disease stage 5 on peritoneal dialysis and there is little evidence in the literature in this population. The objective of our study was to know the prevalence, treatment and professionals involved in the management of atrial fibrillation in peritoneal dialysis patients. For this purpose, we performed a descriptive analysis through a survey sent to different peritoneal dialysis units in Spain. A total of 1403 patients on peritoneal dialysis were included in the study, of whom 186 (13.2%) had non -valvular atrial fibrillation. In addition, the assessment of the scores of thromboembolic and bleeding risks for the indication of oral anticoagulation was mainly carried out by the cardiologist (60% of the units), as well as its prescription (cardiologist 47% in consensus with the nephrologist 43%). In summary, patients on peritoneal dialysis have a remarkable prevalence of non -valvular atrial fibrillation. Patients frequently receive oral anticoagulation with vitamin K antagonists, as well as direct oral anticoagulants. The data obtained regarding the scales used for the assessment of thromboembolic and bleeding risk, treatment and involvement by Nephrology indicates that there is a need for training and involvement of the nephrologist in this pathology . (c) 2023 Sociedad Espanola de Nefrolog & imath;<acute accent>a. Published by Elsevier Espa na, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).