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心房颤动是临床最常见心律失常之一,也是卒中的重要危险因素,抗凝治疗是心房颤动患者卒中预防的重要策略.然而,合并慢性肾脏病的心房颤动患者,面临着更高的卒中、系统性栓塞风险,同时抗凝治疗的出血风险也增高.如何平衡临床抗凝治疗的风险、获益成为临床医师面临的挑战.现对心房颤动合并慢性肾脏病患者流行病学特点、抗凝治疗的策略及风险与获益做一综述.“,”Atrial fibrillation(AF) is one of the most common arrhythmia in clinical practice,and a significant risk for stroke.Anticoagulation is an important strategy for stroke prevention in patients with atrial fibrillation.However,chronic kidney disease is associated with an increased risk of stroke or systemic thromboembolism among patients with atrial fibrillation,and the risk of bleeding is also increased when receiving anticoagulant therapy.It is difficult to balance risks and benefits in clinical practice.This article reviews the epidemiological features,anticoagulation strategy and its risks and effects.