{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:39:10Z","timestamp":1790800750030,"version":"4.1.0"},"reference-count":84,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad Cooperativa de Colombia"},{"id":[{"id":"https:\/\/ror.org\/04td15k45","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Atrial fibrillation (AF) and end-stage renal disease (ESRD) are closely related conditions that increase the risk of disability, stroke, and mortality. Anticoagulation management in patients with ESRD and AF is challenging due to the high risk of bleeding. Percutaneous left atrial appendage closure (LAAC) has emerged as an alternative to reduce thromboembolic events; however, evidence in this specific population remains limited. Therefore, we aimed to evaluate the frequency of thromboembolic events, bleeding complications and mortality in patients with AF and ESRD undergoing LAAC through a systematic review and meta-analysis. Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines and registered in PROSPERO (CRD420250640241). A structured search was performed in Medline, EMBASE, Web of Science, SCOPUS, LILACs and institutional repositories through September 2024, with no language restrictions. We included original studies reporting frequencies of thromboembolic events, bleeding and mortality in patients with AF and ESRD undergoing LAAC. A random-effects model was used and heterogeneity was assessed using the I2 statistic. Results: Fourteen studies were included in the qualitative analysis and seven in the quantitative synthesis, comprising a total of 2433 patients with AF and ESRD undergoing LAAC. In the qualitative analysis, the mean age was 74 \u00b1 7.6 years; the most common comorbidities were hypertension (74%), diabetes mellitus (47%), and dyslipidemia (53%). Watchman\u2122 devices predominated in North America, whereas Amulet\u2122 devices were more frequently used in Europe and Latin America. Procedural success was 98.4%, with infrequent periprocedural complications: major bleeding in 1.6% and device embolization in 0.5%. In the quantitative analysis, the pooled frequency of thromboembolic events was 3% (95% CI: 1\u20137%; I2 = 81.1%), pooled bleeding frequency was 6% (95% CI: 4\u201310%; I2 = 76.9%), and pooled mortality was 5% (95% CI: 1\u201322%; I2 = 97.8%). After excluding studies with extreme values, adjusted mortality was 2% (95% CI: 1\u20135%; I2 = 76.6%). Despite high heterogeneity, the findings suggest that LAAC may offer protection against embolic events with an acceptable bleeding risk. Conclusions: LAAC in patients with AF and ESRD is associated with a low frequency of thromboembolic events and bleeding when compared with standard anticoagulation therapy and no treatment. Overall mortality is moderate and appears to be primarily attributable to underlying comorbidity rather than the procedure itself. This meta-analysis provides evidence that LAAC may be a safe and effective therapeutic strategy in patients with contraindications or high risk for chronic anticoagulation. However, prospective and comparative clinical trials are needed to confirm these findings and inform future clinical practice guidelines.<\/jats:p>","DOI":"10.3390\/jcm15072641","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:09:18Z","timestamp":1774944558000},"page":"2641","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Systematic Review and Meta-Analysis of the Frequency of Thromboembolic Events, Bleeding, and Mortality in Patients with Atrial Fibrillation and End-Stage Renal Disease Undergoing Percutaneous Left Atrial Appendage Closure"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8563-4875","authenticated-orcid":false,"given":"Juan Manuel","family":"Mart\u00ednez-Arango","sequence":"first","affiliation":[{"name":"Internal Medicine, School of Medicine, Medell\u00edn\u2013Envigado Campus, Universidad Cooperativa de Colombia, Medell\u00edn 050026, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0374-5502","authenticated-orcid":false,"given":"Laura Mar\u00eda","family":"Rojas-Echavarr\u00eda","sequence":"additional","affiliation":[{"name":"Medicine, School of Medicine, Medell\u00edn Campus, Universidad CES, Medell\u00edn 050021, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Garc\u00eda-Mej\u00eda","sequence":"additional","affiliation":[{"name":"Internal Medicine, School of Medicine, Medell\u00edn\u2013Envigado Campus, Universidad Cooperativa de Colombia, Medell\u00edn 050026, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Daniel","family":"Castrill\u00f3n-Spitia","sequence":"additional","affiliation":[{"name":"Internal Medicine, School of Medicine, Medell\u00edn\u2013Envigado Campus, Universidad Cooperativa de Colombia, Medell\u00edn 050026, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Felipe","family":"Higuita-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Research Unit, School of Medicine, Medell\u00edn\u2013Envigado Campus, Universidad Cooperativa de Colombia, Medell\u00edn 050026, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e167517","DOI":"10.1172\/JCI167517","article-title":"Chronic kidney disease promotes atrial fibrillation via inflammasome pathway activation","volume":"133","author":"Song","year":"2023","journal-title":"J. Clin. Investig."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1413","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100786","DOI":"10.1016\/j.lanepe.2023.100786","article-title":"Atrial fibrillation: Epidemiology, screening and digital health","volume":"37","author":"Linz","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"US Preventive Services Task Force (2022). Screening for Atrial Fibrillation: US Preventive Services Task Force Recommendation Statement. JAMA, 327, 360\u2013367.","DOI":"10.1001\/jama.2021.23732"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Li, H., Song, X., Liang, Y., Bai, X., Liu-Huo, W.-S., Tang, C., Chen, W., and Zhao, L. (2022). Global, regional, and national burden of disease study of atrial fibrillation\/flutter, 1990\u20132019: Results from a global burden of disease study, 2019. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14403-2"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.cjco.2024.11.017","article-title":"Trends in Global Burden and Socioeconomic Profiles of Atrial Fibrillation and Atrial Flutter: Insights from the Global Burden of Disease Study 2021","volume":"7","author":"Tan","year":"2024","journal-title":"CJC Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1001\/jama.2024.22451","article-title":"Atrial Fibrillation: A Review","volume":"333","author":"Ko","year":"2025","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Son, M.K., Lim, N.-K., Kim, H.W., and Park, H.-Y. (2017). Risk of ischemic stroke after atrial fibrillation diagnosis: A national sample cohort. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0179687"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1111\/jgs.17087","article-title":"Long-term individual and population functional outcomes in older adults with atrial fibrillation","volume":"69","author":"Parks","year":"2021","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1093\/ndt\/gfv009","article-title":"Chronic kidney disease and the risk of stroke: A systematic review and meta-analysis","volume":"30","author":"Masson","year":"2015","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.2215\/CJN.04060318","article-title":"Incident Atrial Fibrillation and the Risk of Stroke in Adults with Chronic Kidney Disease: The Stockholm CREAtinine Measurements (SCREAM) Project","volume":"13","author":"Carrero","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.jvir.2019.04.016","article-title":"Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions-Part I: Review of Anticoagulation Agents and Clinical Considerations: Endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe","volume":"30","author":"Davidson","year":"2019","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1053\/j.ajkd.2005.07.044","article-title":"Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients","volume":"46","author":"Genovesi","year":"2005","journal-title":"Am. J. Kidney Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1681\/ASN.2010050459","article-title":"The increasing prevalence of atrial fibrillation among hemodialysis patients","volume":"22","author":"Winkelmayer","year":"2011","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1038\/ki.2011.416","article-title":"The prevalence of and factors associated with chronic atrial fibrillation in Medicare\/Medicaid-eligible dialysis patients","volume":"81","author":"Wetmore","year":"2012","journal-title":"Kidney Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1016\/j.jacc.2016.06.057","article-title":"Atrial Fibrillation and Thromboembolism in Patients with Chronic Kidney Disease","volume":"68","author":"Lau","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1161\/CIRCULATIONAHA.108.816082","article-title":"ATRIA Study Investigators. Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: The anticoagulation and risk factors in atrial fibrillation (ATRIA) study","volume":"119","author":"Go","year":"2009","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJMoa1105594","article-title":"Stroke and bleeding in atrial fibrillation with chronic kidney disease","volume":"367","author":"Olesen","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.phrs.2017.12.004","article-title":"Bleeding in advanced CKD patients on antithrombotic medication\u2014A critical appraisal","volume":"129","author":"Burlacu","year":"2018","journal-title":"Pharmacol. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1681\/ASN.2008070802","article-title":"Kidney function influences warfarin responsiveness and hemorrhagic complications","volume":"20","author":"Limdi","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"181","DOI":"10.7326\/M19-0087","article-title":"Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis","volume":"171","author":"Ha","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jacc.2019.10.059","article-title":"Oral Anticoagulation for Patients with Atrial Fibrillation on Long-Term Hemodialysis","volume":"75","author":"Kuno","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1378\/chest.15-1719","article-title":"Stroke, Major Bleeding, and Mortality Outcomes in Warfarin Users with Atrial Fibrillation and Chronic Kidney Disease: A Meta-Analysis of Observational Studies","volume":"149","author":"Dahal","year":"2016","journal-title":"Chest"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Shen, X.-F., Zhang, C., Hu, J., Zhang, T., and Ma, B. (2023). Anticoagulant drugs for patients with atrial fibrillation on dialysis: A systematic analysis and network meta-analysis. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1320939"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Rogula, S., G\u0105secka, A., Mazurek, T., Navarese, E.P., Szarpak, \u0141., and Filipiak, K.J. (2022). Safety and Efficacy of DOACs in Patients with Advanced and End-Stage Renal Disease. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031436"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3122","DOI":"10.1016\/j.jacc.2020.04.067","article-title":"Left Atrial Appendage Closure Versus Direct Oral Anticoagulants in High-Risk Patients with Atrial Fibrillation","volume":"75","author":"Osmancik","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2964","DOI":"10.1016\/j.jacc.2017.10.021","article-title":"5-Year Outcomes After Left Atrial Appendage Closure: From the PREVAIL and PROTECT AF Trials","volume":"70","author":"Reddy","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2878","DOI":"10.1016\/j.jacc.2019.09.064","article-title":"Long-Term Safety and Efficacy in Continued Access Left Atrial Appendage Closure Registries","volume":"74","author":"Holmes","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/S0140-6736(09)61343-X","article-title":"Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: A randomised non-inferiority trial","volume":"374","author":"Holmes","year":"2009","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2014.04.029","article-title":"Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: The PREVAIL trial","volume":"64","author":"Holmes","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1093\/ndt\/gfae121","article-title":"Treatment strategies of the thromboembolic risk in kidney failure patients with atrial fibrillation","volume":"39","author":"Genovesi","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e64016","DOI":"10.2196\/64016","article-title":"MetaAnalysisOnline.com: Web-Based Tool for the Rapid Meta-Analysis of Clinical and Epidemiological Studies","volume":"27","author":"Fekete","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"euad315","DOI":"10.1093\/europace\/euad315","article-title":"Prognostic value of chronic kidney disease in patients undergoing left atrial appendage occlusion","volume":"25","author":"Magnocavallo","year":"2023","journal-title":"Europace"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1016\/j.jcin.2021.06.008","article-title":"The Association of Chronic Kidney Disease With Outcomes Following Percutaneous Left Atrial Appendage Closure","volume":"14","author":"Ahuja","year":"2021","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_35","first-page":"610","article-title":"Left atrial appendage closure in end-stage renal disease and hemodialysis: Data from a German multicenter registry","volume":"101","author":"Fink","year":"2023","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/pace.14537","article-title":"Left atrial appendage closure using WATCHMAN device in chronic kidney disease and end-stage renal disease patients","volume":"45","author":"Jamal","year":"2022","journal-title":"PACE\u2014Pacing Clin. Electrophysiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.hroo.2021.08.002","article-title":"Association of chronic kidney disease and end-stage renal disease with procedural complications and in-hospital outcomes from left atrial appendage occlusion device implantation in patients with atrial fibrillation: Insights from the national inpatient sample of 36,065 procedures","volume":"2","author":"Munir","year":"2021","journal-title":"Heart Rhythm. O2"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2683","DOI":"10.1093\/ckj\/sfad221","article-title":"Long-term safety and efficacy of left atrial appendage occlusion in dialysis patients with atrial fibrillation: A multi-center, prospective, open label, observational study","volume":"16","author":"Genovesi","year":"2023","journal-title":"Clin. Kidney J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.ijcard.2018.03.083","article-title":"Implant success and safety of left atrial appendage occlusion in end stage renal disease patients: Peri-procedural outcomes from an Italian dialysis population","volume":"262","author":"Genovesi","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"euaf198","DOI":"10.1093\/europace\/euaf198","article-title":"Left Atrial Appendage Occlusion in Patients with End-Stage Renal Disease: An Individual Patient-Level Meta-Analysis","volume":"27","author":"Vemulapalli","year":"2025","journal-title":"Europace"},{"key":"ref_41","first-page":"1","article-title":"Giornale Italiano di Nefrologia","volume":"1","author":"Manes","year":"2020","journal-title":"G. Ital. Nefrol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s12928-022-00904-9","article-title":"Initial report of percutaneous left atrial appendage closure in hemodialysis patients with atrial fibrillation and high risk of bleeding in Japan","volume":"38","author":"Ueno","year":"2023","journal-title":"Cardiovasc. Interv. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/aor.13603","article-title":"Percutaneous left atrial appendage closure, a safe alternative to anticoagulation for patients with nonvalvular atrial fibrillation and end-stage renal disease on hemodialysis: A single center experience","volume":"44","author":"Xipell","year":"2020","journal-title":"Artif. Organs"},{"key":"ref_44","first-page":"e69286","article-title":"Left Atrial Appendage Closure: A Single-Center Experience in a Population With a High Prevalence of End-Stage Renal Disease","volume":"16","author":"Areiza","year":"2024","journal-title":"Cureus"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Basabe, E., De La Flor, J.C., de la Manzanara, V.L., Nombela-Franco, L., Narv\u00e1ez-Mej\u00eda, C., Cruzado, L., Villa, D., Zamora, R., Tapia, M., and Sastre, M.A. (2024). Percutaneous Left Atrial Appendage Closure in Patients with Non-Valvular Atrial Fibrillation and End-Stage Renal Disease on Hemodialysis: A Case Series. Medicina, 60.","DOI":"10.3390\/medicina60020231"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s00392-020-01638-5","article-title":"Left atrial appendage closure in patients with chronic kidney disease: Results from the German multicentre LAARGE registry","volume":"110","author":"Fastner","year":"2021","journal-title":"Clin. Res. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.ijcard.2016.01.003","article-title":"Impact of chronic kidney disease on left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation","volume":"207","author":"Kefer","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e034176","DOI":"10.1161\/JAHA.123.034176","article-title":"Anticoagulation for Patients with Concomitant Atrial Fibrillation and End-Stage Renal Disease: A Systematic Review and Network Meta-Analysis","volume":"13","author":"Kao","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1161\/CIRCULATIONAHA.118.035418","article-title":"Outcomes associated with apixaban use in patients with end stage kidney disease and atrial fibrillation in the United States","volume":"138","author":"Siontis","year":"2018","journal-title":"Circulation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1681\/ASN.2020111566","article-title":"Safety and efficacy of vitamin K antagonists versus rivaroxaban in hemodialysis patients with atrial fibrillation: A multicenter randomized controlled trial","volume":"32","year":"2021","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/ejh.13599","article-title":"Safety of apixaban compared to warfarin in hemodialysis patients: Do antiplatelets make a difference?","volume":"106","author":"Ionescu","year":"2021","journal-title":"Eur. J. Haematol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1161\/CIRCULATIONAHA.121.054990","article-title":"Apixaban for patients with atrial fibrillation on hemodialysis: A multicenter randomized controlled trial","volume":"146","author":"Pokorney","year":"2022","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1161\/CIRCULATIONAHA.122.062779","article-title":"A randomized controlled trial comparing apixaban with the vitamin K antagonist phenprocoumon in patients on chronic hemodialysis: The AXADIA-AFNET 8 study","volume":"147","author":"Reinecke","year":"2023","journal-title":"Circulation"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1053\/j.ajkd.2022.03.007","article-title":"Apixaban dosing patterns versus warfarin in patients with nonvalvular atrial fibrillation receiving dialysis: A retrospective cohort study","volume":"80","author":"Wetmore","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"ref_55","first-page":"33","article-title":"Incidence of thromboembolic stroke and of major bleeding in patients with atrial fibrillation and chronic kidney disease treated with and without warfarin","volume":"2","author":"Lai","year":"2009","journal-title":"Int. J. Nephrol. Renov. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.2215\/CJN.04550511","article-title":"Effectiveness and safety of warfarin initiation in older hemodialysis patients with incident atrial fibrillation","volume":"6","author":"Winkelmayer","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1161\/CIRCULATIONAHA.113.004777","article-title":"Warfarin use and the risk for stroke and bleeding in patients with atrial fibrillation undergoing dialysis","volume":"129","author":"Shah","year":"2014","journal-title":"Circulation"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1007\/s10157-013-0885-6","article-title":"Association between warfarin use and incidence of ischemic stroke in Japanese hemodialysis patients with chronic sustained atrial fibrillation: A prospective cohort study","volume":"18","author":"Wakasugi","year":"2014","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1053\/j.ajkd.2015.05.019","article-title":"Outcomes after warfarin initiation in a cohort of hemodialysis patients with newly diagnosed atrial fibrillation","volume":"66","author":"Shen","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijcard.2016.07.118","article-title":"Atrial fibrillation and chronic kidney disease requiring hemodialysis-does warfarin therapy improve the risks of this lethal combination?","volume":"222","author":"Garg","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s10157-015-1205-0","article-title":"Warfarin Study Group. Safety of warfarin therapy in chronic hemodialysis patients: A prospective cohort study","volume":"20","author":"Hayashi","year":"2016","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jjcc.2015.08.023","article-title":"Clinical characteristics of hemodialysis patients with atrial fibrillation: The RAKUEN (registry of atrial fibrillation in chronic kidney disease under hemodialysis from Niigata) study","volume":"68","author":"Mitsuma","year":"2016","journal-title":"J. Cardiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1159\/000443448","article-title":"Risk of cerebral infarction in Japanese hemodialysis patients: Miyazaki dialysis cohort study (MID study)","volume":"41","author":"Toida","year":"2016","journal-title":"Kidney Blood Press. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.hlc.2015.08.012","article-title":"Relationships between anticoagulation, risk scores and adverse outcomes in dialysis patients with atrial fibrillation","volume":"25","author":"Wang","year":"2016","journal-title":"Heart Lung Circ."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1007\/s00380-015-0777-7","article-title":"Warfarin use and incidence of stroke in Japanese hemodialysis patients with atrial fibrillation","volume":"31","author":"Yodogawa","year":"2016","journal-title":"Heart Vessel."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.hrthm.2017.01.047","article-title":"Warfarin use and the risk of mortality, stroke, and bleeding in hemodialysis patients with atrial fibrillation","volume":"14","author":"Kai","year":"2017","journal-title":"Heart Rhythm."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jcma.2016.10.012","article-title":"Association of warfarin with congestive heart failure and peripheral artery occlusive disease in hemodialysis patients with atrial fibrillation","volume":"80","author":"Lee","year":"2017","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1161\/STROKEAHA.117.017114","article-title":"Warfarin use in patients with atrial fibrillation undergoing hemodialysis: A nationwide population-based study","volume":"48","author":"Yoon","year":"2017","journal-title":"Stroke"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s40256-019-00347-3","article-title":"Effect of warfarin on ischemic stroke, bleeding, and mortality in patients with atrial fibrillation receiving peritoneal dialysis","volume":"19","author":"Phan","year":"2019","journal-title":"Am. J. Cardiovasc. Drugs"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/nep.13207","article-title":"Warfarin use and the risk of stroke, bleeding, and mortality in older adults on dialysis with incident atrial fibrillation","volume":"24","author":"Tan","year":"2019","journal-title":"Nephrology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1177\/1060028017694654","article-title":"Safety outcomes of apixaban compared with warfarin in patients with end stage renal disease","volume":"51","author":"Sarratt","year":"2017","journal-title":"Ann. Pharmacother."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/rth2.12083","article-title":"Safety and effectiveness of apixaban compared to warfarin in dialysis patients","volume":"2","author":"Reed","year":"2018","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"101104","DOI":"10.1016\/j.cpcardiol.2022.101104","article-title":"Warfarin usage in patients with atrial fibrillation undergoing hemodialysis in Indonesian population","volume":"48","author":"Akbar","year":"2023","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1681\/ASN.2009030319","article-title":"Warfarin use associates with increased risk for stroke in hemodialysis patients with atrial fibrillation","volume":"20","author":"Chan","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1159\/000448898","article-title":"Patients\u2019 characteristics affect the survival benefit of warfarin treatment for hemodialysis patients with atrial fibrillation. A historical cohort study","volume":"44","author":"Brancaccio","year":"2016","journal-title":"Am. J. Nephrol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/ndt\/gfx199","article-title":"Vitamin K antagonist use and mortality in dialysis patients","volume":"33","author":"Voskamp","year":"2018","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2742","DOI":"10.1016\/j.jacep.2025.08.014","article-title":"Impact of device compression on peridevice leak after left atrial appendage closure: The Impression LAAC study","volume":"11","author":"Galea","year":"2025","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.carrev.2024.08.016","article-title":"Adverse outcomes with left atrial appendage occlusion device implantation in chronic and end stage kidney disease: A systematic review and meta-analysis","volume":"75","author":"Gill","year":"2025","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e38935","DOI":"10.1097\/MD.0000000000038935","article-title":"Impact of chronic kidney disease on left atrial appendage occlusion: A meta-analysis of procedural outcomes and complications","volume":"103","author":"Lee","year":"2024","journal-title":"Medicine"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Liu, C., Han, S., Cui, K., and Wang, F. (2023). Efficacy and safety of patients with chronic kidney disease undergoing left atrial appendage closure for atrial fibrillation. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0287928"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1007\/s00392-023-02359-1","article-title":"Transcatheter left atrial appendage occlusion in patients with chronic kidney disease: A systematic review and meta-analysis","volume":"113","author":"Asghar","year":"2024","journal-title":"Clin. Res. Cardiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"443","DOI":"10.31083\/j.rcm.2020.03.62","article-title":"Efficacy and safety of left atrial appendage occlusion in atrial fibrillation patients with chronic kidney disease: A systematic review and meta-analysis","volume":"21","author":"Zhang","year":"2020","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e2530990","DOI":"10.1001\/jamanetworkopen.2025.30990","article-title":"Left Atrial Appendage Occlusion vs Anticoagulants in Dialysis With Atrial Fibrillation","volume":"8","author":"Dhar","year":"2025","journal-title":"AMA Netw. Open"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"131605","DOI":"10.1016\/j.ijcard.2023.131605","article-title":"Multimorbidity in atrial fibrillation for clinical implications using the Charlson Comorbidity Index","volume":"398","author":"Jung","year":"2024","journal-title":"Int. J. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/7\/2641\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:11:05Z","timestamp":1775059865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/7\/2641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":84,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jcm15072641"],"URL":"https:\/\/doi.org\/10.3390\/jcm15072641","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}