Anticoagulation in CKD: Trials and Tribulations

Compared with the general population, patients with chronic kidney disease (CKD) are more likely to experience cardiovascular comorbid conditions such as atrial fibrillation (AF).1 Both CKD and AF independently lead to a prothrombotic state, increasing the risk of ischemic stroke.2 Although stroke risk can be reduced with an anticoagulant in those with AF, patients with CKD are also prone to bleeding,2 and declining kidney function may cause accumulation of renally cleared anticoagulants. So, in balancing both thromboembolic and bleeding risks, what is the optimal treatment plan for patients with CKD and AF?