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Risks of Death and Stroke in Patients Undergoing Hemodialysis With New-Onset Atrial Fibrillation: A Competing-Risk Analysis of a Nationwide Cohort.
CONCLUSIONS: -The risk of stroke was only modestly higher in patients undergoing hemodialysis with new-onset AF than in those without AF, and it became insignificant when accounting for the competing risk of in-hospital death. PMID: 26680239 [PubMed - as supplied by publisher]
Source: Circulation - December 17, 2015 Category: Cardiology Authors: Shih CJ, Ou SM, Chao PW, Kuo SC, Lee YJ, Yang CY, Tarng DC, Lin CC, Huang PH, Li SY, Chen YT Tags: Circulation Source Type: research

Warfarin Use and the Risk for Stroke and Bleeding in Patients with Atrial Fibrillation Undergoing Dialysis.
CONCLUSIONS: Our results suggest that warfarin use is not beneficial in reducing stroke risk but is associated with a higher bleeding risk in patients with AF undergoing dialysis. PMID: 24452752 [PubMed - as supplied by publisher]
Source: Circulation - January 22, 2014 Category: Cardiology Authors: Shah M, Avgil Tsadok M, Jackevicius CA, Essebag V, Eisenberg MJ, Rahme E, Humphries KH, Tu JV, Behlouli H, Guo H, Pilote L Tags: Circulation Source Type: research

Obesity Paradox in Patients Hospitalized for Acute Ischemic Stroke: An Analysis of Nationwide Inpatient Sample Data (S47.008)
Conclusions: Among patients hospitalized for AIS, obese patients had lower risk adjusted in-hospital mortality. Similar trend persisted among IV-tpa and non IV-tpa group. The association of obesity and better prognosis, also known as the "obesity paradox" holds true for AIS. This is the first study of its kind on the largest all payer database. However, further studies are required to establish causal relationship for this phenomenon.Disclosure: Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Savani has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Jani has nothing to disclose. ...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Lunagariya, A., Patel, A., Savani, C., Patel, U., Jani, V., Hussain, S., Mehta, S. Tags: IV-tPA and Endovascular Therapy 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

Inflammatory and Metabolic Syndrome Biomarker Analysis of Vascular Outcomes in End-stage Renal Disease
Int J Angiol DOI: 10.1055/s-0036-1593409End-stage renal disease (ESRD) presents a complex syndrome in which inflammatory and metabolic processes contribute to disease progression and development of comorbid conditions. Over $1 trillion is spent globally on ESRD care.Plasma samples collected from 83 ESRD patients prior to hemodialysis were profiled for metabolic and inflammatory biomarker concentrations. Concentrations were compared between groups with and without history of stroke, acute coronary syndrome (ACS), congestive heart failure (CHF), and coronary artery disease (CAD).The 25 patients (30.1%) with history of stroke...
Source: International Journal of Angiology - October 4, 2016 Category: Cardiology Authors: Sweigert, Patrick J. Bansal, Vinod K. Hoppensteadt, Debra A. Saluk, Jennifer L. Syed, Daneyal A. Fareed, Jawed Tags: Original Article Source Type: research

Clinical characteristics of hemodialysis patients with atrial fibrillation: The RAKUEN (Registry of atrial fibrillation in chronic kidney disease under hemodialysis from Niigata) study.
CONCLUSIONS: In our hemodialysis patients, AF was a common comorbidity and was independently associated with all-cause death and major bleeding, but not with increased risk of ischemic stroke. PMID: 26527113 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - October 30, 2015 Category: Cardiology Authors: Mitsuma W, Matsubara T, Hatada K, Imai S, Saito N, Shimada H, Miyazaki S Tags: J Cardiol Source Type: research

Low‐dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5‐y prospective cohort study
In this study, 406 patients on regular HD were involved during a 5‐y follow‐up. Among these, 152 and 254 propensity‐matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the nonaspirin users (log rank χ2 = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all‐cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased in the aspirin users (HR...
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Jun Liu, Yu Pan, Lei Chen, Qing Yan Qiao, Jing Wang, Li Hua Pan, Yan Hong Gu, Hui Fang Gu, Shun Kun Fu, Hui Min Jin Tags: Original Article Source Type: research

Low ‐dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5‐y prospective cohort study
In this study, 406 patients on regular HD were involved during a 5‐y follow‐up. Among these, 152 and 254 propensity‐matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the nonaspirin users (log rank χ2 = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all‐cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased in the aspirin users (HR...
Source: Hemodialysis International - February 29, 2016 Category: Hematology Authors: Jun Liu, Yu Pan, Lei Chen, Qing Yan Qiao, Jing Wang, Li Hua Pan, Yan Hong Gu, Hui Fang Gu, Shun Kun Fu, Hui Min Jin Tags: Original Article Source Type: research

Prevalence of Atrial Fibrillation and Antithrombotic Therapy in Hemodialysis Patients: Cross-Sectional Results of the Vienna InVestigation of AtriaL Fibrillation and Thromboembolism in Patients on HemoDIalysis (VIVALDI)
ConclusionsThe prevalence of AF is high amongst HD patients and is associated with age, sex, and distinct comorbidities. Practice patterns of antithrombotic treatment indicate a lack of consensus for stroke prevention in HD patients with AF.
Source: PLoS One - January 3, 2017 Category: Biomedical Science Authors: Oliver K önigsbrügge Source Type: research

Medicare Bundled Payment Policy on Anemia Care, Major Adverse Cardiovascular Events, and Mortality among Adults Undergoing Hemodialysis
CONCLUSIONS: The Medicare reimbursement policy and Food and Drug Administration-recommended erythropoietin-stimulating agent dosing changes were associated with lower erythropoietin-stimulating agent use and lower hemoglobin levels. These changes in anemia care were associated with lower risks of major adverse cardiovascular event, stroke, mortality, and heart failure but higher risk of acute myocardial infarction among adults receiving hemodialysis.PMID:35589388 | DOI:10.2215/CJN.14361121
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 19, 2022 Category: Urology & Nephrology Authors: Haesuk Park Raj Desai Xinyue Liu Steven M Smith Juan Hincapie-Castillo Linda Henry Amie Goodin Saraswathi Gopal Carl J Pepine Raj Mohandas Source Type: research

Anatomic Brain Disease in Hemodialysis Patients: A Cross-sectional Study
Background: Although dialysis patients are at high risk of stroke and have a high burden of cognitive impairment, there are few reports of anatomic brain findings in the hemodialysis population. Using magnetic resonance imaging of the brain, we compared the prevalence of brain abnormalities in hemodialysis patients with that in a control population without known kidney disease. Study Design: Cross-sectional cohort. Setting & Participants: 45 maintenance hemodialysis patients and 67 controls without reported kidney disease, both without history of known stroke. Predictor: The primary predictor was dialysis status. Co...
Source: American Journal of Kidney Diseases - October 5, 2012 Category: Urology & Nephrology Authors: David A. Drew, Rafeeque Bhadelia, Hocine Tighiouart, Vera Novak, Tammy M. Scott, Kristina V. Lou, Kamran Shaffi, Daniel E. Weiner, Mark J. Sarnak Tags: Dialysis Source Type: research

Predictors of Operative Mortality in Cardiac Surgical Patients with Prolonged Intensive Care Unit Duration
Background: Several systems have been developed to predict mortality after intensive care unit (ICU) admission in medical and surgical patients. However, a similar tool specific to cardiac surgical patients with prolonged ICU duration does not exist. The purpose of the current study was to identify independent perioperative predictors of operative mortality among cardiac surgical patients with prolonged ICU duration.Study Design: From 2003 to 2008, a total of 13,105 cardiac surgical patients with ICU durations>48 hours were identified within a statewide database. Perioperative factors, including Society of Thoracic Surgeo...
Source: Journal of the American College of Surgeons - April 24, 2013 Category: Surgery Authors: Damien J. LaPar, Jacob R. Gillen, Ivan K. Crosby, Robert G. Sawyer, Christine L. Lau, Irving L. Kron, Gorav Ailawadi Tags: Original Scientific Articles Source Type: research

A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients
Conclusions: Greater IDWG is associated with an increased risk of CV morbid events. Strategies that mitigate IDWG may improve CV health and survival among hemodialysis patients.
Source: BMC Nephrology - July 22, 2015 Category: Urology & Nephrology Authors: Claudia CabreraSteven BrunelliDavid RosenbaumEmmanuel AnumKarthik RamakrishnanDonna JensenNils-Olov StålhammarBergur Stefánsson Source Type: research

Ambulatory Pulse Wave Velocity Is a Stronger Predictor of Cardiovascular Events and All-Cause Mortality Than Office and Ambulatory Blood Pressure in Hemodialysis PatientsNovelty and Significance Arterial Stiffness
This study examines the prognostic significance of ambulatory brachial BP, central BP, pulse wave velocity (PWV), and heart rate–adjusted augmentation index [AIx(75)] in this population. A total of 170 hemodialysis patients underwent 48-hour ambulatory monitoring with Mobil-O-Graph-NG during a standard interdialytic interval and followed-up for 28.1±11.2 months. The primary end point was a combination of all-cause death, nonfatal myocardial infarction, and nonfatal stroke. Secondary end points included: (1) all-cause mortality; (2) cardiovascular mortality; and (3) a combination of cardiovascular death, nonfatal myocard...
Source: Hypertension - June 7, 2017 Category: Cardiology Authors: Pantelis A. Sarafidis, Charalampos Loutradis, Antonios Karpetas, Georgios Tzanis, Alexia Piperidou, Georgios Koutroumpas, Vasilios Raptis, Christos Syrgkanis, Vasilios Liakopoulos, Georgios Efstratiadis, Gerard London, Carmine Zoccali Tags: Nephrology and Kidney, Cardiovascular Disease, Hypertension, Mortality/Survival Original Articles Source Type: research

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