evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2018-2-64-82evrazkar-289Research ArticleОБЗОРREVIEWАНТИКОАГУЛЯНТНАЯ ТЕРАПИЯ ПРИ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК И ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ: ОСЬ ВРАЩЕНИЯ МЕЖДУ ПОЛЮСАМИ РИСКАANTICOAGULANT THERAPY FOR CHRONIC KIDNEY DISEASE AND ATRIAL FIBRILLATION: THE AXIS OF ROTATION BETWEEN THE POLES OF RISKКобалаваЖ. Д.KobalavaZ. D.

Д.м.н., профессор, заведующая кафедрой внутренних болезней с курсом кардиологии и функциональной диагностики

117198, г. Москва, ул. Миклухо-Маклая, д. 6

тел. 8(499)134-6591

Ph.D., professor, head of the Department of Internal Diseases with the course of cardiology and functional diagnostics

117198, Moscow, ul. Miklukho-Maklaya

Tel. 8(499)134-6591

kobalava_zhd@rudn.universityШаваровА. А.ShavarovA. A.

К.м.н., доцент, доцент кафедры внутренних болезней с курсом кардиологии и функциональной диагностики

117198, г. Москва, ул. Миклухо-Маклая, д. 6.

тел. 8(499)135-9177

Candidate of medical science, associate professor, associate professor of the Department of Internal Diseases with the course of cardiology and functional diagnostics 

117198, Moscow, ul. Miklukho-Maklaya, 6

Tel. 8(499)135-9177

shavarov@yahoo.comФГАОУ ВО «Российский университет дружбы народов»РоссияPeoples' Friendship University of RussiaRussian Federation201830062018026482Copyright © Кобалава Ж.Д., Шаваров А.А., 20182018Кобалава Ж.Д., Шаваров А.А.Kobalava Z.D., Shavarov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/289

Частая коморбидность фибрилляции предсердий (ФП) и хронической болезни почек (ХБП) в общей популяции продемонстрирована во многих эпидемиологических исследованиях. Большинству пациентов c установленным диагнозом ФП рекомендована постоянная антикоагулянтная терапии (АКТ) с целью профилактики ишемического инсульта и тромбоэмболических осложнений (ТЭО). При дисфункции почек на всех стадиях ХБП наблюдаются изменения в системе гемостаза, связанные как с повышением протромбогенной активности, так и развитием коагулопатии, увеличивающей угрозу кровотечения. Поэтому у пациентов с ХБП и ФП важным аспектом АКТ является выбор оптимального антикоагулянта, обеспечивающего баланс между рисками инсульта и геморрагических осложнений, чему и посвящена данная статья.

The frequent comorbidity of atrial fibrillation (AF) and chronic kidney disease (CKD) in the general population is demonstrated in many epidemiological studies. Most patients with an established diagnosis of AF are recommended to use constant anticoagulant therapy (ACT) to prevent ischemic stroke and thromboembolic complications (TEC). With renal dysfunction, changes in the hemostatic system are observed at all stages of CKD, both related to an increase in prothrombogenic activity as well as to development of coagulopathy, which increases the threat of bleeding. Therefore, in patients with CKD and AF, an important aspect of ACT is the choice of the optimal anticoagulant, that will provide a balance between the risks of stroke and hemorrhagic complications, to which this article is dedicated.

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The authors declare that there are no conflicts of interest present.