Atrial Fibrillation in Kidney Failure: Challenges in Risk Assessment and Anticoagulation Management.

2 Another meta-analysis of 12 studies, including people on peritoneal dialysis, kidney transplant recipients, and people with stage 5 CKD only, reported a nonsignificant trend toward reduction in ischemic stroke with a significant increase in total bleeding risk and no effect on mortality. 39 The association between VKAs and accelerated vascular calcification also warrants careful consideration. 40 Aside from inhibiting VKA-dependent coagulation factors, off-target effects include interfering with vitamin K-dependent inhibitors of vascular arterial media calcification.

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24 The prognostic significance of these episodes is unclear, and there is likely to be significant clinician variability in OAC practice in this population.

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