USE OF ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION AND CHRONIC KIDNEY DISEASE

Abstract

Atrial fibrillation (AF) is a common arrhythmia that increases the risk of stroke and other thromboembolic complications. Treatment with oral anticoagulants (OCs) is often indicated to prevent these events in patients with AF. However, the use of OCs in patients with chronic kidney disease (CKD) presents specific challenges due to changes in the pharmacokinetics and pharmacodynamics of the drugs, which may affect the efficacy and safety of treatment. This integrative review aims to analyze the efficacy and safety of OCs in patients with AF and CKD, focusing on current guidelines, clinical trial results, and practical recommendations. Studies that compared the effects of different OCs, such as warfarin, rivaroxaban, apixaban, and dabigatran, in patients with varying stages of CKD were included. Data analysis revealed that although new-generation OACs offer advantages in terms of monitoring and predictability, the choice of anticoagulant should be individualized based on the patient's renal function, risk profile, and comorbidities. The findings highlight the importance of dose adjustment strategies and close monitoring to optimize anticoagulant therapy in patients with AF and CKD.