A NATIONAL SURVEY ON ANTICOAGULATION PRACTICES IN HEMODIALYSIS PATIENTS WITH ATRIAL FIBRILLATION

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A NATIONAL SURVEY ON ANTICOAGULATION PRACTICES IN HEMODIALYSIS PATIENTS WITH ATRIAL FIBRILLATION

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Co-author 1

salma naouaoui salma.naouaoui@um6p.ma um6p general hospital, smart healthcare city nephrology department Ben Guerir Morocco *

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Introduction

Atrial fibrillation (AF) is common in individuals with end stage renal disease on hemodialysis. Such patients have an increased risk of both embolic stroke and bleeding. However, limited data is available regarding the utility of anticoagulation in this population due to limited evidence from randomized trials. Therefore, our study aimed to assess current clinical practices regarding anticoagulation in dialysis patients with AF.

Methods

We developed a web-based and multidisciplinary survey to explore the current beliefs and practices concerning anticoagulation for patients with AF on dialysis. The survey was distributed to nephrologists and cardiologists across the country. The questionnaire included items on respondent demographics, anticoagulation indications, preferred agents, risk stratification tools (CHA₂DS₂-VASc, HAS-BLED), and perceived challenges in this population.

Results

A total of 89 physicians (58 nephrologists and 31 cardiologists) completed the survey. While 70% reported managing dialysis patients with AF, only 56% routinely prescribed anticoagulation. The most commonly used anticoagulant was warfarin. Only 48% routinely used CHA₂DS₂-VASc and HAS-BLED scores in clinical decision-making. A history of calciphylaxis has influenced the decision to prescribe anticoagulation among all respondents. The main barriers to anticoagulation included fear of bleeding (90%) and lack of evidence-based guidelines (57%).

Conclusion

our survey showed that there is significant variability regarding anticoagulation practices in dialysis patients with AF. These findings highlight the urgent need for large clinical trials to assess the safety and effectiveness of anticoagulation in AF patients on dialysis.

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