Key points are not available for this paper at this time.
Direct oral anticoagulants have replaced vitamin K antagonists in the general population with nonvalvular atrial fibrillation due to their predictable anticoagulation profile, similar efficacy, and superior safety. However, their benefits remain unclear in patients on dialysis because studies involving apixaban were underpowered to determine their noninferiority to warfarin,1,2 and some concerns have been raised regarding their potential for accumulation and the risk of bleeding.3 These concerns are supported by a preliminary study in which a single 5 mg dose of apixaban, given immediately after a 4-hour session (off hemodialysis HD), resulted in a 36% increase in the area under the curve (AUC), indicating overexposure compared to healthy subjects.
Otero et al. (Fri,) studied this question.