Anticoagulants in atrial fibrillation patients with chronic kidney disease

Atrial fibrillation and chronic kidney disease (CKD) frequently coexist and confer an increased risk of stroke. Novel anticoagulants are attractive options over warfarin but undergo renal clearance to varying degrees, and therefore require special consideration in patients with CKD. Recent studies also challenge the benefits of warfarin anticoagulation for atrial fibrillation patients undergoing haemodialysis. This Review discusses the data relating to anticoagulation in patients with atrial fibrillation and CKD and highlights the need for further studies to delineate the optimal use of new anticoagulant agents in patients with CKD.