A frail 82-year-old with non-valvular atrial fibrillation weighs 48 kg and has serum creatinine 118 micromol/L; the laboratory reports eGFR 43

Question

A frail 82-year-old with non-valvular atrial fibrillation weighs 48 kg and has serum creatinine 118 micromol/L; the laboratory reports eGFR 43 mL/min/1.73 m². A DOAC is being considered. What must occur before selecting the agent and dose?

Accepted Answer

Calculate Cockcroft-Gault clearance using actual weight, then apply drug-specific criteria

Answer

Assume normal renal function from the serum creatinine reference range

Answer

Choose a prophylactic postoperative dose on the basis of frailty

Answer

Avoid every DOAC when eGFR is below 50 mL/min/1.73 m²

Answer

Use eGFR 43 directly when applying the selected DOAC summary of product characteristics

AF Anticoagulation in CKD — PSA MCQ

A frail 82-year-old with non-valvular atrial fibrillation weighs 48 kg and has serum creatinine 118 micromol/L; the laboratory reports eGFR 43 mL/min/1.73 m². A DOAC is being considered. What must occur before selecting the agent and dose?