Same rhythm, different song - approaches to atrial fibrillation management by cardiologists and nephrologists

Mark, P. B. , Del Vecchio, L., Valdivielso, J. M. and Malyszko, J. (2021) Same rhythm, different song - approaches to atrial fibrillation management by cardiologists and nephrologists. Clinical Kidney Journal, 14(1), pp. 9-13. (doi: 10.1093/ckj/sfaa146) (PMID:33564401) (PMCID:PMC7857826)

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Abstract

Atrial fibrillation (AF) is common in patients with chronic kidney disease (CKD), affecting 10–25% of patients requiring dialysis. Compared with the general population, patients requiring dialysis are also at increased risk of stroke, the major thromboembolic complication of AF. The evidence base for management strategies of AF specific to patients with advanced CKD is limited and not informed by randomized controlled trials. These gaps in evidence encompass rate and rhythm control strategies as well as a paucity of data informing which patients should receive anticoagulation. The European Renal Association–European Dialysis and Transplant Association and European Heart Rhythm Association undertook a survey of nephrologists and cardiologists exploring management strategies in patients with AF and CKD. We review the results of this survey, highlighting the differences in clinical approaches from cardiologists and nephrologists to these conditions. Closer collaboration between these specialties should lead to improved outcomes for patients with advanced CKD and AF. Specific issues that will need to be addressed may include healthcare burden to patients, location of clinics compared with dialysis sites and awareness of complications of treatments specific to CKD, such as calciphylaxis associated with vitamin K antagonism.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mark, Professor Patrick
Authors: Mark, P. B., Del Vecchio, L., Valdivielso, J. M., and Malyszko, J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Kidney Journal
Publisher:Oxford University Press
ISSN:2048-8505
ISSN (Online):2048-8513
Published Online:27 September 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Clinical Kidney Journal 14(1): 9-13
Publisher Policy:Reproduced under a Creative Commons Licence

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