Vztah a klinický význam chronického onemocnění ledvin u pacientů s poruchami srdečního rytmu a/ nebo s implantabilními elektrickými přístroji
Zkrácená komentovaná verze oficiálního stanoviska Evropské společnosti pro srdeční rytmus

Czech version

Authors: P. Heinc; L. Gajdošová; M. Kamasová; J. Látal; J. Přeček; A. Smékal; L. Rec
Authors‘ workplace: I. interní klinika – kardiologická LF UP a FN Olomouc
Published in: Kardiol Rev Int Med 2015, 17(4): 331-338
Category: Cardiology Review

Overview

Chronic kidney disease increases the risk of cardiovascular morbidity and overall mortality, therefore, if heart disease is present, kidney function must be regularly monitored. The pharmacokinetics of drugs is altered in these patients and in dialysed patients the drug may be entirely eliminated from the circulation system, therefore it is necessary to individualise the dose of antiarrhythmic drugs according to the glomerular filtration rate. Catheter ablation for rhythm control is the preferable method in patients with atrial fibrillation. Patients with severe renal insufficiency should not be administered any new anticoagulants; warfarin continues to be indicated instead, with a stricter control of the effective therapeutic range. Patients with implantable electronic devices have a higher risk of complications, especially infectious, and higher total and cardiac mortality. To minimise infectious complications, it is necessary to establish the access route for electrode system implantation on an individual basis, avoid the introduction of dialysis catheter in persons with implants, and where arteriovenous clutches are required, they should be installed on the contralateral side to the implanted device.

Keywords:
kidney disease – heart disease – pharmacokinetics – arrhythmias – thromboembolism – infective complication – implantable electrical devices

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