Фибрилляция предсердий у больных, находящихся на диализной терапии: эпидемиология, прогноз и выбор антикоагулянтной терапии

В обзоре представлены данные по распространенности фибрилляции предсердий (ФП) у больных, находящихся на диализной терапии. Показано, что у диализ-зависимых пациентов с неклапанной ФП прогноз крайне неблагоприятный, значительно увеличен риск смерти как за счет ишемических, так и геморрагических осложнений. Шкалы для оценки риска развития тромбоэмболических и геморрагических осложнений у больных с ФП, находящихся на программном диализе, не валидизированы. Отсутствие данных рандомизированных клинических исследований значительно затрудняет выбор антикоагулянтной терапии у больных с терминальной стадией хронической болезни почек, находящихся на диализе, перенесших трансплантацию почки. Поэтому необходимость антикоагулянтной терапии и выбор препаратов у больных данной категории должен быть сделан на основе персонализированного мультидисциплинарного подхода с учетом коморбидной патологии и предпочтений больного.

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