Warfarin in Patients with A-Fib and CKD

Does warfarin benefit patients with atrial fibrillation and CKD?
Non-end-stage CKD:  yes, lowers risk of ischemic stroke or thromboembolism (HR 0.70), lower mortality (0.65), no excess major bleeding risk – compared with no anticoagulation.
However, those with ESRD (on HD) – no benefit from warfarin on ischemic stroke, thromboembolism or mortality; higher risk for major bleeding (HR 1.30).
Meta-analysis of 11 cohort studies.
This study did not include the newer anticoagulants.
Chest 2016 Apr; 149:951.

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