Oral anticoagulation and left atrial appendage closure in dialysis atrial fibrillation: between stroke prevention and bleeding hazard

Clicks: 1
ID: 318886
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #123 of 128 articles by views in clinical kidney journal

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 128 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Atrial fibrillation (AF) is frequent in dialysis patients and associates with a substantial increase in stroke, cardiovascular events, and mortality, yet the net clinical benefit of oral anticoagulation (OAC) in this setting remains uncertain. Dialysis patients were excluded from pivotal vitamin K antagonists (VKAs) and direct anticoagulants (DOACs) trials, and observational data are conflicting. The PRO position argues that in carefully selected patients with very high thromboembolic risk and acceptable bleeding risk, thromboembolic prophylaxis—pharmacological with OAC or non-pharmacological with left atrial appendage closure (LAAC)—can reduce stroke and possibly mortality. This view is supported by several cohort studies suggesting lower ischemic events and improved survival when OAC is maintained, and international normalized ratio control is good, and by emerging data that LAAC may offer similar stroke protection with less bleeding and lower mortality than OAC or no prophylaxis. The CON position stresses that many large studies show no clear stroke reduction and consistently higher major bleeding with warfarin versus no OAC, that small randomized controlled trials of DOACs versus VKAs reveal very high absolute bleeding without clear efficacy gains, and that VKAs may aggravate vascular calcification. Both positions agree on the need for individualized, shared decision-making and for adequately powered randomized trials comparing OAC and LAAC with no specific therapy in dialysis AF.
Reference Key
openalex_W7166041906 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Simonetta Genovesi, Toshiki Kuno, Jürgen Floege, Carmine Zoccali
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag217
URL
https://doi.org/10.1093/ckj/sfag217
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.