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The prevalence of atrial fibrillation (AF) in patients with end-stage kidney disease (ESKD) is high and increasing. However, evidence regarding oral anticoagulant (OAC) use in these patients is insufficient and conflicting.

This retrospective cohort study included patients in the Korea National Health Insurance System diagnosed with AF after ESKD onset from January 2007 to December 2017. The primary outcome was all-cause death. Secondary outcomes were ischemic stroke, hospitalization for major bleeding, and major adverse cardiovascular events (MACE). Outcomes were compared between OAC users and nonusers using 6-month landmark analysis and 1: 3 propensity score matching.

Among patients with ESKD and AF, the number of prescribed OACs increased 2.3-fold from 2012 (n = 3 579) to 2018 (n = 8 341), and …