What is the clinical benefit of oral anticoagulation in severe CKD?
There is signficant controversy as to the net clinical benefit of oral anticoagulation in severe CKD despite encouraging observational studies. The latest systematic review and meta-analysis by Harel of 14 observational studies found that the use of warfarin was not associated with ischemic stroke or hemorrhagic stroke among patients with AF and receive dialysis. However, there was marked study heterogeneity including the inability to account for major confounders such as the quality of anticoagulation control (TTR).