AIM: There is limited evidence to support the use of oral anticoagulation (OAC) in people with advanced chronic kidney disease (CKD) and atrial fibrillation (AF). The aim of this study is to characterise the practice patterns and priorities of clinicians in the management of non-valvular AF and primary prevention of AF-related stroke in people with stage 4-5D CKD. METHODS: This was an annonymous, multiple-choice, electronic survey distributed to and undertaken by nephrology and cardiology clinicians in Australia and New Zealand. RESULTS: Responses eligible for analysis were received from 181 clinicians (121 nephrology and 60 cardiology respondents). Management with close specialty collaboration was reported by 47% of all respondents. OAC use was predominantly based on estimated individual stroke risk (i.e., CHA CONCLUSIONS: This survey provides important contemporary insights into the management of AF in people with advanced CKD in Australia and New Zealand. There was inter- and intra-specialty heterogeneity in practice, highlighting the need for multidisciplinary care and research to improve cardiovascular outcomes in this population.