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Influence of chronic kidney disease and haemodialysis on stroke outcome
CONCLUSION: Despite significant functional and neurological improvements following rehabilitation, stroke patients with underlying CKD had higher average duration of hospital stay, more recurrent hospitalisations and poorer survival outcomes than those without underlying CKD. This could be attributed to the complications associated with CKD rather than stroke. Multidisciplinary community rehabilitation may be an alternative to reduce recurrent hospitalisations and morbidity in this group of patients. PMID: 32241068 [PubMed - as supplied by publisher]
Source: Singapore Medical Journal - April 2, 2020 Category: General Medicine Authors: Pande SD, Morris J Tags: Singapore Med J Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Hemorrhagic Stroke in Chronic Kidney Disease.
Authors: Jha VK, Sharda V, Mirza SA, Shashibhushan, Bhol KK Abstract Hemorrhagic stroke is leading cause of death in Chronic Kidney Disease (CKD) population. Uremic patients are susceptible to hemorrhagic complications due to multiple reasons i.e platelet dysfunction, low platelet number, use of heparin during hemodialysis, use of anticoagulants for thromboembolic risk etc. Prevention and treatment of hemorrhagic stroke is complicated in CKD setting and if not managed properly can lead to several fold increased mortality and morbidity rate. In this brief review we will discuss about the magnitude of hemorrhagic str...
Source: Journal of the Association of Physicians of India - July 18, 2019 Category: General Medicine Tags: J Assoc Physicians India Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

New aspects of cerebrovascular diseases in dialysis patients.
Authors: Naganuma T, Takemoto Y Abstract Growing evidence suggests that chronic kidney disease is a significant risk factor for stroke, subclinical cerebrovascular abnormalities, and cognitive impairment, independent of known cardiovascular risk factors. Cerebrovascular disease is also a major cause of death in dialysis patients, who have a much higher incidence of stroke compared to the normal population. Strokes in dialysis patients are also characterized by a higher incidence of hypertensive intracerebral hemorrhage compared with those in the general population. Recent studies on dialysis cohorts have shown that...
Source: Contributions to Nephrology - June 1, 2015 Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research

A contemporary evaluation of carotid endarterectomy outcomes in patients with chronic kidney disease in the United States.
Conclusions Patients with ESRD undergoing CEA had an increased risk of respiratory and septic complications, but not a higher risk of stroke compared to patients with normal renal function. The greatest risks of postoperative stroke, respiratory, and cardiac complications were found in patients with CKD. A diagnosis of ESRD and CKD were both found to significantly increase hospital mortality, length of stay and cost. Where clinicians typically consider ESRD patients the highest risk for CEA, further consideration should be given to patients with CKD not yet on dialysis as they had the higher risk of cardiac complications a...
Source: Vascular - December 31, 2016 Category: Surgery Authors: Patel AR, Dombrovskiy VY, Vogel TR Tags: Vascular Source Type: research

Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).
CONCLUSIONS: In studies of adults with CKD G5D treated with dialysis, sevelamer may lower death (all causes) compared to calcium-based binders and incur less treatment-related hypercalcaemia, while we found no clinically important benefits of any phosphate binder on cardiovascular death, myocardial infarction, stroke, fracture or coronary artery calcification. The effects of binders on patient-important outcomes compared to placebo are uncertain. In patients with CKD G2 to G5, the effects of sevelamer, lanthanum, and iron-based phosphate binders on cardiovascular, vascular calcification, and bone outcomes compared to place...
Source: Cochrane Database of Systematic Reviews - August 22, 2018 Category: General Medicine Authors: Ruospo M, Palmer SC, Natale P, Craig JC, Vecchio M, Elder GJ, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Revascularization in Patients With Multivessel Coronary Artery Disease and Chronic Kidney Disease Everolimus-Eluting Stents Versus Coronary Artery Bypass Graft Surgery
ConclusionsIn patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps MI, with no long-term mortality difference. In the subgroup on dialysis, the results favored CABG over PCI.
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology Source Type: research

Direct oral anticoagulants in chronic kidney disease: an update
Purpose of review Direct oral anticoagulants (DOACs) are variably eliminated by the kidneys rendering their use potentially problematic in patients with chronic kidney disease (CKD) or necessitating appropriate dose adjustment. Recent findings Both observational and limited randomized trial data for DOACs compared with no treatment or with warfarin for patients with atrial fibrillation on maintenance dialysis were recently published. In a randomized trial in patients on hemodialysis, there was no significant difference in vascular calcification between patients who received rivaroxaban with or without vitamin K2 or vi...
Source: Current Opinion in Nephrology and Hypertension - August 1, 2020 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

The problem of atrial fibrillation in patients with chronic kidney disease.
Abstract Chronic kidney disease (CKD) is associated with the risk of multiple life-threatening complications such as: progression to chronic renal failure and cardiovascular disease including coronary heart disease, heart failure and peripheral arterial disease. Also, atrial fibrillation (AF) is common in this group of patients. Factors contributing to the occurrence of AF in patients undergoing dialysis include: age, presence of coronary heart disease, echocardiographic abnormalities (low ejection fraction, atrial enlargement, valvular calcification, left ventricular hypertrophy), heart failure, chronic obstructi...
Source: Current Vascular Pharmacology - January 15, 2016 Category: Drugs & Pharmacology Authors: Franczyk B, Gluba-Brzózka A, Ciałkowska-Rysz A, Banach M, Rysz J Tags: Curr Vasc Pharmacol Source Type: research

Serum Glutaredoxin Activity as a Marker of Oxidative Stress in Chronic Kidney Disease: A Pilot Study
Conclusion: Our pilot study indicates that Grx may be a useful marker for assessing the degree of oxidative stress in CKD, however this needs further investigation in a larger prospective patient cohort.Nephron
Source: Nephron - October 5, 2018 Category: Urology & Nephrology Source Type: research

Antiplatelet agents for chronic kidney disease
CONCLUSIONS: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovascular death among people with CKD and those treated with dialysis. The treatment effects of antiplatelet agents compared with each other are uncertain.PMID:35224730 | DOI:10.1002/14651858.CD008834.pub4
Source: Cochrane Database of Systematic Reviews - February 28, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Valeria M Saglimbene Marinella Ruospo Mona Razavian Jonathan C Craig Meg J Jardine Angela C Webster Giovanni Fm Strippoli Source Type: research

RCTs: Peginesatide in patients with anaemia and chronic kidney disease
Source: N Engl J Med Area: News In the New England Journal of Medicine, researchers report the results of four event-driven, randomised, controlled, open-label trials that compared the efficacy and safety of standard erythropoiesis-stimulating agent (ESA) therapy with peginesatide (Omontys), a peptide based ESA approved in the US in March 2012 for the treatment of anaemia caused by chronic kidney disease in adults who are undergoing dialysis.   The EMERALD 1 and EMERALD 2 studies involved patients undergoing haemodialysis. Cardiovascular safety was evaluated by analysis of an adjudicated composite safety end poin...
Source: NeLM - News - January 24, 2013 Category: Drugs & Pharmacology Source Type: news

Kidney disease and cognitive function.
Abstract We provide a brief review of research on chronic kidney disease and cognitive performance, including dementia. We touch briefly on the literature relating end-stage-renal disease to cognitive function, but focus on studies of modest and moderate forms of chronic kidney disease (CKD) that precede dialysis and transplantation. We summarize previous reviews dealing with case control studies of patients but more fully examine community-based studies with large samples and necessary controls for demographic risk factors, cardiovascular variables, and other confounds such as depression. In addition we suggest p...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Elias MF, Dore GA, Davey A Tags: Contrib Nephrol Source Type: research

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