Anticoagulation in Concomittant Chronic Kidney Disease and Atrial Fibrillation: A Case Report
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Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Šis ir klīnisks gadījuma ziņojums par pacientu ar hronisku nieru slimību beigu stadijā, kas attīstās sekundāri ar c-ANCA saistītam vaskulītam. Pirms ar c-ANCA saistīta vaskulīta attīstīšanas pacientam bija pastāvīga priekškambaru mirdzēšana un viņš saņēma insulta profilakses dabigatrānu. Tā kā pacientam bija hroniska nieru slimība beigu stadijā, insulta profilakse tika mainīta uz varfarīnu, tomēr pacients izrādījās rezistents pret to. Tāpēc ziņojumā ir aplūkoti dažādi varianti, kā šādu pacientu varētu alternatīvi antikoagulēt. Turklāt šajā gadījuma ziņojumā ir aplūkota pacientu ārstēšana ar c-ANCA saistītu vaskulītu (pazīstams arī kā granulomatoze ar poliangiītu) ar smagu nieru un plaušu iesaistīšanos.
This is a clinical case report about a patient with end-stage chronic kidney disease developing secondary to c-ANCA-associated vasculitis. Prior to developing c-ANCA associated vasculitis, the patient had permanent atrial fibrillation and received for stroke prevention dabigatran. Due to the patient having end-stage chronic kidney disease, the stroke prophylaxis was changed to warfarin, however, the patient proved resistant to it. Therefore, in the case report are different options discussed, as to how such a patient could be anticoagulated alternatively. Additionally, this case report discusses the management of patients with c-ANCA associated vasculitis (also known as granulomatosis with polyangiitis) with severe renal and pulmonary involvement.
This is a clinical case report about a patient with end-stage chronic kidney disease developing secondary to c-ANCA-associated vasculitis. Prior to developing c-ANCA associated vasculitis, the patient had permanent atrial fibrillation and received for stroke prevention dabigatran. Due to the patient having end-stage chronic kidney disease, the stroke prophylaxis was changed to warfarin, however, the patient proved resistant to it. Therefore, in the case report are different options discussed, as to how such a patient could be anticoagulated alternatively. Additionally, this case report discusses the management of patients with c-ANCA associated vasculitis (also known as granulomatosis with polyangiitis) with severe renal and pulmonary involvement.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Hroniska nieru slimība, HNS, priekškambaru fibrilācija, c-ANCA-asociēts vaskulīts, granulomatozi ar poliangiītu, antikoagulants, tiešais perorālais antikoagulants, apiksabāns, rivaroksabāns, varfarīns, LMWH, gadījumu apraksts, Chronic kidney disease, CKD, atrial fibrillation, AF, c-ANCA-associated vasculitis, granulomatosis with polyangiitis, anticoagulant, direct oral anticoagulant (DOAC), apixaban, rivaroxaban, warfarin, LMWH, case report