(Section 4.1. in the 2014 AF Guideline) IIb B-NR For patients with AF who have a CHA2 - VASc score of 2 or greater in men or 3 or greater in women and who have end-stage chronic kidney disease (CKD; creatinine clearance [CrCl] <15 mL/min) or are on dialysis, it might be reasonable to prescribe warfarin (INR 2.0 to 3.0) or apixaban for MODIFIED: New evidence has been added. LOE was updated from B to B-NR. (Section 4.1. in the 2014 AF Guideline) IIb B-R For patients with AF (except with moderate- to-severe mitral stenosis or a mechanical heart valve) and moderate-to-severe CKD (serum creatinine 1.5 mg/dL [apixaban], CrCl 15 to 30 mL/min [dabigatran], CrCl 50 mL/min [rivaroxaban], or CrCl 15 to 50 mL/ min [edoxaban]) with an elevated CHA2 - VASc score, treatment with reduced doses of direct thrombin or factor Xa inhibitors may be considered (eg, dabigatran, rivaroxaban, apixaban, or edoxaban).S4.1.1-11 MODIFIED: Exclusion criteria are now defined as moderate-to-severe mitral stenosis or a mechanical heart valve, and this recommendation has been changed in response to the approval of edoxaban. LOE was updated from C to B-R. (Section 4.1. in the 2014 AF Guideline) IIb C- LD For patients with AF (except with moderate- to-severe mitral stenosis or a mechanical heart valve) and a CHA2 -VASc score of 1 in men and 2 in women, prescribing an oral anticoagulant to reduce thromboembolic stroke risk may be considered.S4.1.1-31 S4.1.1-35 MODIFIED: Exclusion criteria are now defined as moderate-to-severe mitral stenosis or a mechanical heart valve, and evidence was added to support separate risk scores by sex. LOE was updated from C to C-LD. 