Vitamin K AntagonISt, Factor Xa Inhibitor or No Anticoagulation in Atrial Fibrillation and DIalytic End-stage Renal DiseasE (VISIONAIRE)

Who May Qualify: - Patients with clinical atrial fibrillation or flutter (persistent, paroxysmal or permanent); - CHA2DS2-Vasc ≥ 2 points (≥ 3 if female); - Chronic kidney disease with estimated glomerular filtration rate (eGFR) ≤ 15 ml/min/1.73 m2 by the CKD-EPI equation (confirmed by two lab results at least 3 months apart) or on chronic renal replacement therapy (Of note: number of patients included in no renal replacement therapy stratum will be capped at around 30% from the total study population). Who Should NOT Join This Trial: - Active bleeding or severe bleeding \< 1 month; - Prior kidney transplantation; - Refusal de provide consent - Severe chronic liver disease (Child C); - Other indication of oral anticoagulation (e.g.,: venous thromboembolism or pulmonary embolism); - Prior intracranial hemorrhage; - Bleeding disorder (other than uremia); - Platelet count \< 50,000 / mm3 ; - Pregnancy or breastfeeding; - Mechanical valvar prosthesis; - Moderate to severe mitral stenosis; - Need for antithrombotic drugs other than single antiplatelet agents, or need for dual antiplatelet therapy with aspirin plus an ADP receptor blocker; - Any comorbidity beyond CKD and CV disease (e.g., metastatic cancer) which, in the investigator´s opinion, may impact survival in 12 months. Always talk to your doctor about whether this trial is right for you.