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Dialyse aktuell 2021; 25(07): 266-272
DOI: 10.1055/a-1401-3183
Schwerpunkt
Nephrologie

Antikoagulation bei chronisch nierenkranken Menschen mit Vorhofflimmern

Neue Antikoagulanzien (NOAK), Phenprocoumon oder Verzicht auf Antikoagulation?
Stephan H. Schirmer
1   Stephan H. Schirmer, Kardiopraxis Schirmer, Kaiserslautern
2   Universität des Saarlandes, Homburg/Saar
,
Vincent Brandenburg
3   Klinik für Kardiologie und Nephrologie, Rhein-Maas Klinikum Würselen
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ZUSAMMENFASSUNG

Bei Patienten mit Vorhofflimmern besteht ein erhöhtes Risiko für thromboembolische Komplikationen und insbesondere Schlaganfall. Patienten mit chronischer Nierenerkrankung haben gehäuft Vorhofflimmern und sowohl ein erhöhtes Blutungs- wie auch Schlaganfallrisiko. Für Patienten mit einer Kreatinin-Clearance von bis zu 25–30 ml/min sind Nicht-Vitamin-K-abhängige orale Antikoagulanzien (NOAK) evidenzbasiert zur Schlaganfallprävention den Vitamin-K-Antagonisten (VKA) vorzuziehen. Darunter bzw. bei Dialysepatienten liegen keine wissenschaftlichen Daten vor; hier muss das Konzept (keine Antikoagulation vs. NOAK vs. Vorhofohrverschluss vs. VKA) individuell entschieden werden, wobei die Gabe von VKA die schlechteste Lösung zu sein scheint.



Publication History

Article published online:
10 September 2021

© 2021. Thieme. All rights reserved.

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