Conclusions
In this observational study of new OAC users with AF and stage III CKD, we found that rivaroxaban is safe and effective relative to warfarin but if CrCl is between 30–49 mL/min, we need to reduce the dose at 15 mg. Apixaban 2.5 mg might even have a better safety profile than warfarin, while apixaban 5.0 mg might have a better effectiveness profile than warfarin, to a reduction in deaths. Appropriately sized RCTs are needed to confirm these findings in stage III CKD patients.