Patients with chronic kidney disease (CKD) and atrial fibrillation (AF) face an elevated risk of both ischemic stroke (IS) and treatment-related bleeding. CKD itself predisposes patients to AF, a major risk factor of IS, with AF prevalence ranging from 12% to 27% depending on CKD severity and dialysis status.1 This association is partly explained by shared risk factors, including advanced age, hypertension, smoking, and diabetes. The direct association between CKD severity and IS and bleeding incidence also suggests CKD-specific mechanisms: incidences peak in patients with end-stage kidney disease (ESKD) and rise further after hemodialysis initiation whereas peritoneal dialysis carries a more moderate increase in risk.