Compare Apixaban and Vitamin-K Antagonists in Patients With Atrial Fibrillation (AF) and End-Stage Kidney Disease (ESKD)

Inclusion Criteria: * End-stage kidney disease (ESKD) with chronic hemodialysis treatment 3 times per week (with about at least 3.5 hours per dialysis) * Chronic (i.e. repeated) paroxysmal, persistent or permanent atrial fibrillation (AF) or atrial flutter (AFL) documented by standard or Holter ECG on at least 2 separate days before (or apart from) hemodialysis procedures * Increased risk of stroke or systemic embolism identified by a CHA2DS2-VASc score of 2 or more as an indication for oral anticoagulation * Patients with ischemic stroke that meet the above criteria, can be included after more than 3 months if not severely handicapped (modified Rankin scale 0 or 1 of 6, i.e. no symptoms or no significant disability and able to carry out all usual activities, despite some symptoms (Farrell, Godwin, Richards, and Warlow (1991)) * Males and females, aged 18 or older Exclusion Criteria: * AF or AFL due to reversible causes (e.g., thyrotoxicosis, pericarditis) * Patients with a new onset of hemodialysis within the last 3 months * Clinically significant (moderate or severe) aortic and mitral stenosis * Conditions other than AF or AFL that require chronic anticoagulation (e.g., a prosthetic mechanical heart valve). * Active infective endocarditis * Any planned interventional or surgical AF or AFL ablation procedure * Any active bleeding * A serious bleeding event in the previous 6 months before screening * Inadequately controlled (HbA1c levels \>8.5%) or untreated diabetes * His…