Abstract A 78 years old woman presented in our cardio–oncology out–patient clinic to renew apixaban treatment plan. In her medical history she was a former smoker, with chronic kidney disease IIIb stadium according KDIGOI guidelines creatinine of 1,54 mg/dl, GFR CKD 32 ml/min/1.73m2 and Cockcroft e Gault 28 ml/min/1.73m2. 2010, had right lobe pulmonary cancer diagnosis treated neo–adjuvant gemc...