Abstract
MANAGEMENT OF ATRIAL FIBRILLATION IN PATIENTS ON CHRONIC HEMODIALYSIS: A LITERATURE REVIEW

Jaouad Nguadi, Youssef Lahmouz, Hanae El Ghiati, Jihane Fagouri, Hicham Bouzelmat, Ali Chaib

ABSTRACT

Atrial fibrillation (AF) is highly prevalent in patients on chronic hemodialysis (HD), with an estimated prevalence of 10–27%, posing a major challenge due to elevated risks of ischemic stroke and major bleeding. This review examines epidemiology, pathophysiology, risk assessment, and therapeutic strategies, aligned with the latest societal guidelines (ACC/AHA/ACCP/HRS 2023, ESC 2024). Oral anticoagulation (OAC) remains controversial due to an unfavorable risk-benefit profile, with warfarin preferred in end-stage renal disease (ESRD), while direct oral anticoagulants (DOACs) are restricted. Rate control is prioritized, with rhythm control emerging for symptomatic patients. A multidisciplinary, individualized approach is essential to optimize outcomes.

Keywords: Atrial fibrillation; Chronic hemodialysis; Anticoagulation; Guidelines; End-stage renal disease.


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