Table 1.

DOACs in patients with advanced CKD

	Dosage	Comment
Direct factor Xa inhibitors
Apixaban	eGFR 30–49 mL/min: 2×5 mg/d If >1 additional criteria age >80 years, body weight <60 kg, creatinine >1.5 mg/dL: 2×2.5 mg/d	Renal elimination 27%
Rivaroxaban	eGFR 30–49 mL/min: 10 mg/d	Renal elimination 33%
Edoxaban	eGFR 15–50 mL/min: 30 mg/d	Renal elimination 50%, not recommended if eGFR <30 mL/min
Direct thrombin inhibitors
Dabigatran	eGFR >60 mL/min: 2×150 mg/d	Not recommended if eGFR <60 mL/min; contraindicated if eGFR<30 mL/min; renal elimination 80%

Note: Most data are derived from studies in patients with AF. The dosages for patients with advanced CKD and venous thromboembolism or AF are similar.31,35–38,40,41,68,75,76

Abbreviations: AF, atrial fibrillation; CKD, chronic kidney disease; DOACs, direct oral anticoagulants; eGFR, estimated glomerular filtration rate.