Vorhofflimmern und Antikoagulation bei Niereninsuffizienz

Ein Kerndilemma in der Schlaganfallprävention bei CKD-Patienten liegt einerseits darin, dass eine Antikoagulation mit Vitamin-K-Antagonisten das Gefäßverkalkungsrisiko bei eingeschränkter Nierenfunktion eklatant erhöht, und dass andererseits alternative Antikoagulanzien zumindest teilweise renal eliminiert werden und im Dialysestadium nicht zugelassen sind. Der folgende Artikel soll in erster Linie eine pragmatische Risiko-Nutzen-Abwägung zur Wirksamkeit und Sicherheit der Antikoagulation bei Vorhofflimmern bei Patienten mit fortgeschrittener CKD darstellen.

Schlüsselwörter

Antikoagulation - Vorhofflimmern - Dialyse - Niereninsuffizienz - DOAKs - Vitamin-K-Antagonisten

• Literatur

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