Apixaban is a medication used to prevent blood clots from forming in the body. In this clinical trial, it is being tested to see if it can help reduce the risk of strokes and other serious complications in patients who have a specific type of irregular heartbeat called atrial fibrillation, especially those who also have severe kidney problems. The goal is to find out if taking Apixaban can lower the chances of having a stroke or a clot without causing too much bleeding, which can be a side effect of blood thinners. This medication is being compared to not using any blood-thinning medication to see which approach is safer and more effective for these patients.

Atrial Fibrillation – Atrial fibrillation is a heart condition characterized by an irregular and often rapid heart rate. It occurs when the upper chambers of the heart (atria) beat out of coordination with the lower chambers (ventricles). This can lead to poor blood flow and may cause symptoms like heart palpitations, shortness of breath, and fatigue. Over time, atrial fibrillation can lead to complications such as blood clots, which can increase the risk of stroke. The condition can be persistent or occur in episodes that come and go. It often requires ongoing management to control the heart rate and rhythm.

Chronic Kidney Disease Stage 5 – Chronic Kidney Disease (CKD) stage 5, also known as end-stage renal disease, is the most advanced stage of chronic kidney disease. At this stage, the kidneys have lost nearly all their ability to function effectively, leading to a significant buildup of waste products and fluid in the body. Symptoms may include fatigue, swelling in the legs and ankles, shortness of breath, and difficulty concentrating. The progression to stage 5 often requires interventions to manage the body’s waste products and fluid levels. This stage of CKD can severely impact overall health and quality of life. It typically necessitates ongoing medical care to address the complications associated with kidney failure.