title: End-stage renal disease with atrial fibrillation: uncharted territory in the modern world of anticoagulants.
abstract: BACKGROUND
  End-stage renal disease (ESRD) and atrial fibrillation are increasingly common concurrent findings among many patients. Coexisting ESRD and atrial fibrillation can further exacerbate each disease process; thus, evidence-based medicine protocols are needed for the treatment of patients with both ESRD and new-onset atrial fibrillation to clarify the appropriate anticoagulant management of such patients.
  
  
  METHODS
  The manuscript surveys the literature to look for a suitable answer to the pressing question that requires development of an evidence-based protocol: 'Which anticoagulant is best for the patient with ESRD and atrial fibrillation?'
  
  
  CONCLUSIONS
  Unlike many disease processes that have ample evidence available in order to better manage the patient, in the patient with end-stage kidney disease and new onset of atrial fibrillation, the situation becomes much more complicated. We believe randomized controlled trials for both the classical and the newer oral anticoagulants could provide evidence-based medicine protocols for the treatment of patients with ESRD and new-onset atrial fibrillation.
authors.affiliation: Saba University, School of Medicine , 27 Jackson Road Suite 301, Devens, MA 01434 , USA.
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Browne
authors.forename: Justin
authors.initials: J
authors.lastname: McMaster
authors.forename: Syed A
authors.initials: SA
authors.lastname: Rizvi
authors.forename: Sultan
authors.initials: S
authors.lastname: Ahmed
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000188:drug therapy
chemical_list: D000925:Anticoagulants
keywords: anticoagulant; atrial fibrillation; dialysis; end-stage kidney disease