In a related editorial, the authors comment that two highly anticipated ongoing studies in patients with AF and ESKD, RENAL-AF (RENal Hemodialysis Patients ALlocated Apixaban Versus Warfarin in Atrial Fibrillation) and AXADIA are required to prove efficacy. Until the results of these trials become available, the decision to use anticoagulant therapy in patients with ESKD will continue to require an individualised approach that balances potential benefits and harms.