The report describes prescribing volumes and patient characteristics over time, by medication, and by FDA-labeled use (e.g., ADM, AOM, or unknown)
the benefit was also observed in the population of reduced creatinine clearance145,146 and although the trials were performed in patients with creatinine clearances up to 2530ml/min/1.73m2, there is evidence for some of them of its safety in patients with creatinine clearances up to 15ml/min/1.73m2.147 However, direct oral anticoagulants are not recommended in patients with venous thromboembolism and advanced CKD, or antiphospholipid syndrome, or who are pregnant or lactating.142 The optimal duration of oral anticoagulation will depend on the type of deep vein thrombosis (provoked or unprovoked), the duration of the risk factor (transient or persistent), and the risk of recurrence of venous thromboembolism.141,142 However, no data on patients with diabetes and CKD and reduced eGFR were found in this review

Diabetes Action Canada supported this research by providing access to the NDR and advocating for the inclusion of patient voices and collaborating with stakeholders to improve access to these innovative therapies.
Researchers there studied metabolism intensely
If side effects occur, your clinician can adjust dose timing, pace of increases, or supportive strategies to improve tolerance