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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

Impact of atrial fibrillation on the risk of ischemic stroke in patients on hemodialysis: BOREAS-HD3 Study
ConclusionPresent analyses using comprehensive adjustment for multiple confounders, including prior history of ischemic stroke, indicated that AF independently increases the risk of new-onset of ischemic stroke by more than twofold in Japanese HD patients.
Source: Clinical and Experimental Nephrology - November 18, 2020 Category: Urology & Nephrology Source Type: research

New XARELTO ® (rivaroxaban) Peripheral Artery Disease (PAD) Data from EXPLORER Clinical Research Program to be Unveiled at American Heart Association (AHA) Scientific Sessions 2020
RARITAN, N.J., November 9, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that 10 data presentations will be shared at the virtual American Heart Association (AHA) Scientific Sessions 2020 from November 13-17. Most notably, four new sub-analyses of XARELTO® (rivaroxaban) from the landmark VOYAGER PAD trial, part of the EXPLORER global cardiovascular research program, will be presented, including two live, featured science oral presentations. “We're pleased VOYAGER PAD was selected to be front and center once again at a major medical congress, as there's an urgent need for data in ...
Source: Johnson and Johnson - November 9, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

Effect of Warfarin on Ischemic Stroke, Bleeding, and Mortality in Patients with Atrial Fibrillation Receiving Peritoneal Dialysis
ConclusionThere is no significant association between warfarin treatment with risks of mortality, ischemic stroke or bleeding in patients with atrial fibrillation receiving peritoneal dialysis.
Source: American Journal of Cardiovascular Drugs - April 22, 2019 Category: Cardiology Source Type: research

Stroke in patients with chronic kidney disease & #8230;: How do we approach and manage it ?
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - May 3, 2017 Category: Urology & Nephrology Authors: S Nayak-Rao MP Shenoy Source Type: research

Treatment of atrial fibrillation with warfarin among older adults with end stage renal disease.
CONCLUSION: Despite the unclear benefit and increased bleeding risk of warfarin treatment in patients with ESRD, 1 in 8 older adults undergoing dialysis with incident AF in the US who had high risk of bleeding used warfarin. Changes to warfarin therapy due to discontinuation were common after initiation. PMID: 28120282 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - January 23, 2017 Category: Urology & Nephrology Authors: Tan J, Bae S, Segal JB, Zhu J, Segev DL, Alexander GC, McAdams-DeMarco M Tags: J Nephrol Source Type: research

Risk factors and outcome of Stroke in renal transplant recipients
This article is protected by copyright. All rights reserved.
Source: Clinical Transplantation - May 23, 2016 Category: Transplant Surgery Authors: Mark D. Findlay, Peter C. Thomson, Rachael MacIsaac, Alan G. Jardine, Rajan K. Patel, Kathryn K. Stevens, Elaine Rutherford, Marc Clancy, Colin C. Geddes, Jesse Dawson, Patrick B. Mark Tags: Original Article Source Type: research

Safety of warfarin therapy in chronic hemodialysis patients: a prospective cohort study
Conclusion The results of this study suggested that warfarin use by HD patients might not be harmful in chronic state, while the safety for the initiation of warfarin therapy in HD patients remained to be determined.
Source: Clinical and Experimental Nephrology - December 1, 2015 Category: Urology & Nephrology Source Type: research

Risk Factors of Ischemic Stroke and Subsequent Outcome in Patients Receiving Hemodialysis Clinical Sciences
Conclusions— Incidence of stroke is high in patients with ESRD on hemodialysis with high case-fatality. Incident hemodialysis patients had the highest stroke incidence. Many, but not all, important risk factors commonly associated with stroke in the general population were not associated with stroke in patients receiving hemodialysis.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Findlay, M. D., Thomson, P. C., Fulton, R. L., Solbu, M. D., Jardine, A. G., Patel, R. K., Stevens, K. K., Geddes, C. C., Dawson, J., Mark, P. B. Tags: Cerebrovascular disease/stroke, Risk Factors for Stroke, Epidemiology Clinical Sciences 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

Stroke feature and management in dialysis patients.
Abstract Strokes remain the major complication among dialysis population as the number of diabetes and elderly is increasing. In chronic hemodialysis patients, prevalence and incidence of stroke is higher than that of the general population. According to the annual registry data of the Japanese Society for Dialysis Therapy, prevalence of stroke death has been declining, yet the incidence of nonfatal incidence of stroke is not known. Underlying mechanisms of stroke are multiple. Among them, control of hypertension is important for the primary prevention; however, the ideal target level of blood pressure is not dete...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Iseki K Tags: Contrib Nephrol Source Type: research