RESUMO
Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillars for the prevention of thromboembolic events. However, there are no randomized clinical trials on the risk-benefit profile of oral anticoagulation in patients with chronic kidney disease stage 5 on peritoneal dialysis and there is little evidence in the literature in this population. The objective of our study was to know the prevalence, treatment and professionals involved in the management of atrial fibrillation in peritoneal dialysis patients. For this purpose, we performed a descriptive analysis through a survey sent to different peritoneal dialysis units in Spain. A total of 1,403 patients on peritoneal dialysis were included in the study, of whom 186 (13.2%) had non-valvular atrial fibrillation. In addition, the assessment of the scores of thromboembolic and bleeding risks for the indication of oral anticoagulation was mainly carried out by the cardiologist (60% of the units), as well as its prescription (cardiologist 47% or in consensus with the nephrologist 43%). In summary, patients on peritoneal dialysis have a remarkable prevalence of non-valvular atrial fibrillation. Patients frequently receive oral anticoagulation with vitamin K antagonists, as well as direct oral anticoagulants. The data obtained regarding the scores used for the assessment of thromboembolic and bleeding risk, treatment and involvement by Nephrology indicates that there is a need for training and involvement of the nephrologist in this pathology.
Assuntos
Anticoagulantes , Fibrilação Atrial , Diálise Peritoneal , Humanos , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/complicações , Diálise Peritoneal/efeitos adversos , Prevalência , Masculino , Feminino , Anticoagulantes/uso terapêutico , Anticoagulantes/efeitos adversos , Espanha/epidemiologia , Idoso , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Tromboembolia/prevenção & controle , Tromboembolia/etiologia , Tromboembolia/epidemiologia , Cardiologistas , Administração OralAssuntos
Vírus JC , Transplante de Rim , Infecções por Polyomavirus , Humanos , Masculino , Complicações Pós-Operatórias/virologia , Complicações Pós-Operatórias/etiologia , Nefropatias/virologia , Nefropatias/etiologia , Infecções Tumorais por Vírus , Pessoa de Meia-Idade , Hospedeiro ImunocomprometidoRESUMO
Differentiation of hypertrophic cardiomyopathy phenotypes is challenging but crucial for appropriate management. We report a case of myocardial oxalate deposition as an infrequent cause of infiltrative cardiomyopathy.
