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Subjects with non valvualr atrial fibrillation and CKD stage 3 and 4
First choice Apixaban 2.5mg BID in the presence of one or more additional criteria: age≥80years, body weight
≤60kg
Second choice Dabigatran 110mg twice daily
Subjects with nonvalvular atrial fibrillation on maintenance dialysis
First choice No anti coagulation or VKA is appropriate
Not recommended Dabigatran,rivaroxaban, apixaban*,or edoxaban
Subjects with nonvalvular atrial fibrillation and stage 1 CKD
First choice Dabigatran 150 mg BID, rivaroxaban 20 mg OD or apixaban 5mg BID
Table 2: European Society of Cardiology (ESC) recommendations for NOAC’s use in CKD subjects[1]

VKA= Vitamin K anticoagulants | *FDA approved apixaban in hemodialysis patients

References
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Non vitamin-K dependent oral anticoagulants (NOACs) in chronic kidney
disease patients with non-valvular atrial fibrillation. G Ital Nefrol. 2017
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