The prevalence of atrial fibrillation and venous thromboembolism will rise over the next decades due to foreseeable demographic developments. Anticoagulation treatment for these patients will become increasingly challenging due to the rising prevalence of chronic kidney disease (CKD), which is associated with both an increased risk of bleeding and impaired efficacy of oral anticoagulation (OAC). New oral anticoagulants (NOAC) are excreted by the kidneys and may thus accumulate in patients with CKD leading to an increased risk of bleeding; therefore, the pharmacological properties of NOACs have to be considered in order to avoid serious complications. Analysis of the currently available evidence for patients with CKD provides important insights for everyday clinical practice.