Chronic kidney disease and arrhythmias: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Abstract

eCrCl (mL/min) a Warfarin Apixaban b Dabigatran Edoxaban c Rivaroxaban >95 Adjusted dose (INR 2-3) 5 mg b.i.d. 150 mg b.i.d. 60 mg QD d 20 mg QD 51-95 Adjusted dose (INR 2-3) 5 mg b.i.d. 150 mg b.i.d. 60 mg QD 20 mg QD 31-50 Adjusted dose (INR 2-3) 5 mg b.i.d.(eCrCl cut-off 25 mL/min) 150 mg b.i.d. or 110 mg b.i.d. e 30 mg QD 15 mg QD INR, international normalized ratio. a Cockcroft-Gault estimated creatinine clearance (eCrCl). b Apixaban dose modification from 5 mg b.i.d. to 2.5 mg b.i.d. if patient has any two of the following: serum creatinine > _1.5 mg/dL, age > _80 years, or body weight < _60 kg. c In the ENGAGE-AF TIMI 48 study, the dose was halved if any of the following: eCrCl of 30-50 mL/min, body weight < _60 kg, or concomitant use of verapamil or quinidine (potent P-glycoprotein inhibitors). d This dose has not been approved for use by the US Food and Drug Administration in this category of kidney function. e In countries where 110 mg b.i.d. is approved, clinicians may prefer this dose after clinical assessment of thromboembolic vs bleeding risk. This dose has not been approved for use by the US Food and Drug Administration.