Abstract: FR-PO901
Atrial Fibrillation in Non-Dialysis Dependent CKD: Prevalence and Time in Therapeutic Range in Patients Anticoagulated With Vitamin K Antagonists
Session Information
- CKD: Epidemiology, Risk Factors, Prevention - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention
Authors
- Rodriguez-Espinosa, Diana, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Broseta Monzo, Jose Jesus, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Cases, Aleix, Universitat de Barcelona, Barcelona, Catalunya, Spain
Background
Atrial fibrillation (AF) and chronic kidney disease (CKD) are two closely related entities since not only do they frequently coexist, but one increases the development and progression of the other and vice versa, as well as sharing many risk factors such as age, arterial hypertension, diabetes mellitus or heart failure.
In addition, these patients are more prone to poor therapeutic control, although it has been described that the prevalence of AF in CKD is up to 20% and that these patients tend to achieve an INR in the therapeutic range of around 70%. This study aims to determine the true prevalence of this entity in elderly patients with advanced stages of CKD, as well as to determine the time in which acenocoumarol is maintained in the therapeutic range (TTR) in these individuals.
Methods
Retrospective observational study of a randomized sample of non-dialysis dependent CKD (NDD-CKD) patients followed at our hospital. Demographic, medical history, and laboratory data were taken from electronic health records. Time in the therapeutic range was calculated with the Rosendaal method
Results
A total of 114 cases were analyzed. The mean age was 79 years, 52.2% were men, their body mass index was 29.24 kg/m2, their estimated glomerular filtration rate was 22.9 ml/min/1.73m2 and their mean Charlson comorbidity index was 8. The prevalence of AF was 35%. And this was significantly associated with the presence of heart failure (52.8% vs 9.3%, p<0.001). Half of the patients were anticoagulated with acenocoumarol and the other half with direct-acting anticoagulants (DOACs). Among the former, the mean TTR was 55%. Only 38.5% of patients anticoagulated with acenocoumarol had optimal TTR (>65%).
Conclusion
AF is more prevalent in elderly people with NDD-CKD. This population has greater difficulty than the general population in maintaining an optimal TTR level with vitamin K antagonists, increasing both their risk of bleeding and thrombosis. The population with NND-CKD could benefit from the use of DOACs in the face of this difficulty.