The American journal of medicine
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Because differences in renal function can affect the efficacy and safety of direct oral anticoagulants, prescribing an appropriate dose based on renal function is critical, especially in patient populations with a high incidence of renal impairment. In patients with nonvalvular atrial fibrillation and mild or moderate renal impairment, direct oral anticoagulants are associated with a better risk-benefit profile compared with warfarin. ⋯ We summarize the available data on direct oral anticoagulant use in patients with venous thromboembolism and renal impairment. Clinicians are encouraged to follow study inclusion/exclusion criteria and perform renal dose adjustments based on the Cockcroft-Gault equation using actual body weight when indicated to avoid adverse events.