Chronic kidney disease (CKD) is a common complication of diabetes. More than 40% of diabetic patients have atrial fibrillation AF – complicating treatment. Most guidelines recommend anticoagulation therapy for AF patients. However, in diabetes patients with CKD, a more cautious approach is required. In this article we look at optimal treatment of these studies, guideline recommendations as well as studies that were completed after the publication of these guidelines.