{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T03:04:25Z","timestamp":1783825465290,"version":"3.55.0"},"reference-count":82,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>The incidence and prevalence of atrial fibrillation (AF) in patients affected by kidney failure, i.e. glomerular filtration rate &amp;lt;15\u00a0ml\/min\/1.73\u00a0m2, is high and probably underestimated. Numerous uncertainties remain regarding how to prevent thromboembolic events in this population because both cardiology and nephrology guidelines do not provide clear recommendations. The efficacy and safety of oral anticoagulant therapy (OAC) in preventing thromboembolism in patients with kidney failure and AF has not been demonstrated for either vitamin K antagonists (VKAs) or direct anticoagulants (DOACs). Moreover, it remains unclear which is more effective and safer, because estimated creatinine clearance &amp;lt;25\u201330\u00a0ml\/min was an exclusion criterion in the randomized controlled trials (RCTs). Three RCTs comparing DOACs and VKAs in kidney failure failed to reach the primary endpoint, as they were underpowered. The left atrial appendage is the main source of thromboembolism in the presence of AF. Left atrial appendage closure (LAAC) has recently been proposed as an alternative to OAC. RCTs comparing the efficacy and safety of LAAC versus OAC in kidney failure were terminated prematurely due to recruitment failure. A recent prospective study showed a reduction in thromboembolic events in haemodialysis patients with AF and undergoing LAAC compared with patients taking or not taking OAC. We review current treatment standards and discuss recent developments in managing the thromboembolic risk in kidney failure patients with AF. The importance of shared decision-making with the multidisciplinary team and the patient to consider individual risks and benefits of each treatment option is underlined.<\/jats:p>","DOI":"10.1093\/ndt\/gfae121","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T12:58:29Z","timestamp":1716987509000},"page":"1248-1257","source":"Crossref","is-referenced-by-count":13,"title":["Treatment strategies of the thromboembolic risk in kidney failure patients with atrial fibrillation"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4699-4149","authenticated-orcid":false,"given":"Simonetta","family":"Genovesi","sequence":"first","affiliation":[{"name":"School of Medicine and Surgery, University of Milano-Bicocca, Nephrology Clinic , Monza , Italy"},{"name":"Istituto Auxologico Italiano, IRCCS , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2536-2871","authenticated-orcid":false,"given":"A John","family":"Camm","sequence":"additional","affiliation":[{"name":"St. George's University of London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9985-2486","authenticated-orcid":false,"given":"Adrian","family":"Covic","sequence":"additional","affiliation":[{"name":"Nephrology Clinic, Dialysis and Renal Transplant Center \u2013 \u2018C.I. Parhon\u2019 University Hospital \u00a0 , Iasi , Romania"},{"name":"and 'Grigore T. Popa\u2019 University of Medicine \u00a0 , Iasi , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3424-1588","authenticated-orcid":false,"given":"Alexandru","family":"Burlacu","sequence":"additional","affiliation":[{"name":"Nephrology Clinic, Dialysis and Renal Transplant Center \u2013 \u2018C.I. Parhon\u2019 University Hospital \u00a0 , Iasi , Romania"},{"name":"and 'Grigore T. Popa\u2019 University of Medicine \u00a0 , Iasi , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-2026","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Meijers","sequence":"additional","affiliation":[{"name":"Nephrology Unit, University Hospitals Leuven and Department of Microbiology, Immunology and Organ Transplantation , KU Leuven, Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1004-9994","authenticated-orcid":false,"given":"Casper","family":"Franssen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7066-8135","authenticated-orcid":false,"given":"Valerie","family":"Luyckx","sequence":"additional","affiliation":[{"name":"Renal Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA , USA"},{"name":"Department of Paediatrics and Child Health, University of Cape Town , South Africa"},{"name":"Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7564-2724","authenticated-orcid":false,"given":"Vassilios","family":"Liakopoulos","sequence":"additional","affiliation":[{"name":"Second Department of Nephrology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0591-8622","authenticated-orcid":false,"given":"Gaetano","family":"Alfano","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Transplant Unit, University Hospital of Modena , Modena , 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