Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease

Aim: To investigate the efficacy and safety profile of oral anticoagulants and determine the best treatment for patients with atrial fibrillation (AF) and chronic kidney disease (CKD ). Methods and materials: A systematic assessment of literature from Pubmed/MEDLINE was performed in search of studies evaluating the efficacy, safety, pharmacokinetics, and pharmacodynamics of direct oral anticoagulants (DOACs) and warfarin in patients with CKD . Results: According to guidelines, DOACs are the treatment of choice for patients with CKD 1–3 (Crcl ≥ 30 mL/min) due to their high efficacy, better safety profile, and fewer food/drug and drug/ drug interactions than warfarin. For patients with CKD 4 (Crcl 15-29 mL/min), there are no such strong recommendations as to which group of anticoagulants is the better choice, and for those with CKD 5 (Crcl