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More Studies Required to Understand Mortality Rates of Dialysis-Dependent Patients after Acute Thrombolysis for Stroke
I read with interest the article by Tariq et al in the Journal that details outcomes with thrombolytic therapy for acute ischemic stroke in over 1000 dialysis patients. They are to be commended for examining this important aspect of acute stroke care in dialysis cohorts. However, in their discussion, the authors state that a previous US study by Sozio et al reported a 30-day mortality rate of 35% after thrombolysis. This is inaccurate and can potentially cause confusion. In fact, careful review of the article reveals that the authors of that study do not report any thrombolysis-related outcomes and that this mortality ra...
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2013 Category: Neurology Authors: Albert Power Tags: Letters to the Editor Source Type: research

Cerebrorenal interaction and stroke.
Abstract Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microb...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Toyoda K Tags: Contrib Nephrol Source Type: research

Outcomes of endovascular versus intravenous thrombolytic treatment for acute ischemic stroke in dialysis patients.
CONCLUSIONS: The odds of both in-hospital mortality and moderate to severe disability were lower with endovascular treatment in dialysis patients. Such data support the preferential use of endovascular treatment in this patient population. PMID: 25262635 [PubMed - as supplied by publisher]
Source: The International Journal of Artificial Organs - September 27, 2014 Category: Transplant Surgery Authors: Saeed F, Adil MM, Piracha BH, Qureshi AI Tags: Int J Artif Organs Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding, and Mortality in Patients With Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. Although randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit patients on dialysis. We thus undertook this systematic review and meta-analysis of observational studies including patients with AF on dialysis that reported associations of anticoagulation use. Twenty studies involving 529,741 subjects and 31,321 patients with AF on dialysis were identified. Anticoagulation was associated with a 45% (95% CI 13% to 88%) increased risk of any stroke, reflecting a nonsignificant 13% (95% CI −4% to 34...
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Tags: Arrhythmias and Conduction Disturbances Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding and Mortality in Patients with Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. While randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit dialysis patients. We thus undertook this systematic review and meta-analysis of observational studies. Electronic databases were searched for studies including AF patients on dialysis that reported observational associations of anticoagulation use. Twenty-one studies involving 530,031 individuals and 31,611 AF patients on dialysis were identified.
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Source Type: research

Neurological Involvement in Primary Systemic Vasculitis
Conclusion Neurological involvement is a common complication of PSV (Table 1), and neurologists play an important role in the identification and diagnosis of PSV patients with otherwise unexplained neurological symptoms as their chief complaint. This article summarizes the neurological manifestations of PSV and hopes to improve neuroscientists' understanding of this broad range of diseases. TABLE 1 Table 1. Common CNS and PNS involvements of primary systemic vasculitis. Author Contributions SZ conceived the article and wrote the manuscript. DY and GT reviewed and edited the manuscript. All authors ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Progeria syndrome in CKD/ESRD
Conclusions: Renal impairment independently associates with greater stroke disability at presentation and worse functional outcomes despite modern stroke care. Nonetheless these patients are also less likely to be thrombolysed for acute ischaemic stroke, which suggests a possible inequity in access to healthcare that requires urgent study.
Source: Nephrology Dialysis Transplantation - May 10, 2013 Category: Urology & Nephrology Authors: Power, A., Gill, D., Wietek, N., Lim, J., Tanna, R., Duncan, N., Troyano Suarez, N., Del Nogal Avila, M., Mora Valenciano, I., Olmos Centenero, G., Diez-Marques, M. L., Cortes, M., Lopez Ongil, S., Martin Sanchez, P., Rodriguez Puyol, D., Ruiz Torres, M. Tags: Abstracts Source Type: research

Efficacy and Safety of Direct Oral Anticoagulants vs Warfarin in Patients with Chronic Kidney Disease and Dialysis Patients: A Systematic Review and Meta-Analysis
ConclusionsIn pooled, analyzed randomized controlled trials and observational studies, DOACs were associated with better efficacy in early CKD, as well as similar efficacy and safety outcomes to warfarin in patients with CKD stages 4 –5 or dialysis patients. The results of patients with CKD stages 4–5 and dialysis patients were from observational studies. Well-designed randomized controlled trials focused on DOAC use in patients with CKD and dialysis patients are needed.PROSPERO register number: CRD42020150599, 6 February, 2020.
Source: Clinical Drug Investigation - March 11, 2021 Category: Drugs & Pharmacology Source Type: research

Apixaban versus No Anticoagulation in Patients Undergoing Long-Term Dialysis with Incident Atrial Fibrillation.
CONCLUSIONS: In patients with kidney failure and nonvalvular atrial fibrillation, treatment with apixaban was not associated with a lower incidence of new stroke, transient ischemic attack, or systemic thromboembolism but was associated with a higher incidence of fatal or intracranial bleeding. PMID: 32444398 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 21, 2020 Category: Urology & Nephrology Authors: Mavrakanas TA, Garlo K, Charytan DM Tags: Clin J Am Soc Nephrol Source Type: research

Cardiovascular and renal outcomes in patients with atrial fibrillation and stage 4 –5 chronic kidney disease receiving direct oral anticoagulants: a multicenter retrospective cohort study
AbstractThe role of direct oral anticoagulants (DOAC) in patients with atrial fibrillation (AF) and stage 4 –5 chronic kidney disease (CKD) is controversial. Electronic medical records from 2012 to 2021 were retrieved for patients with AF and stage 4–5 CKD receiving oral anticoagulants. Patients were separated into those receiving DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) or vitamin K ant agonists (VKA). Primary outcomes included ischemic stroke (IS), systemic thrombosis (SE), major bleeding, gastrointestinal bleeding, hemorrhagic stroke, acute myocardial infarction, cardiovascular death, and all-cause dea...
Source: Journal of Thrombosis and Thrombolysis - August 21, 2023 Category: Hematology Source Type: research

A predictive model of complications after spine surgery: the National Surgical Quality Improvement Program (NSQIP) 2005–2010
Conclusions: Our model can provide individualized estimates of the risks of postoperative complications based on preoperative conditions, and can potentially be used as an adjunct in decision-making for spine surgery.
Source: The Spine Journal - November 8, 2013 Category: Orthopaedics Authors: Kimon Bekelis, Atman Desai, Samuel F. Bakhoum, Symeon Missios Tags: Clinical Studies Source Type: research

Safety and Efficacy of Apixaban Versus Warfarin in Patients With Advanced Chronic Kidney Disease.
Conclusion and Relevance: Patients with advanced CKD taking apixaban had similar bleeding rates at 3 months compared with those taking warfarin. However, those who continued therapy had higher major bleeding rates with warfarin between 6 and 12 months. This study provides knowledge on the effects of a direct oral anticoagulant in a population that was excluded from all major trials. PMID: 29871510 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - June 1, 2018 Category: Drugs & Pharmacology Authors: Schafer JH, Casey AL, Dupre KA, Staubes BA Tags: Ann Pharmacother Source Type: research

Outcome of redo surgical aortic valve replacement in patients ≥ 80 years: results from the multicenter RECORD initiative.
CONCLUSIONS: Octogenarians undergoing S-AVR after prior cardiac surgery have similar immediate postoperative outcome to younger patients and their 5-year outcome is excellent. These data suggest that indication to TAVR should not rely only on coexistence of advanced age and history of prior cardiac surgery. PMID: 24036070 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - September 10, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Onorati F, Biancari F, De Feo M, Mariscalco G, Messina A, Santarpino G, Santini F, Beghi C, Nappi G, Troise G, Fischlein T, Passerone G, Heikkinen J, Faggian G Tags: Ann Thorac Surg Source Type: research

Regulation of the epithelial Na+ channel by the mTORC2/SGK1 pathway
The epithelial Na+ channel (ENaC) is decisive for sodium reabsorption by the aldosterone-sensitive distal nephron (ASDN) of the kidney. ENaC is regulated by the serum- and glucocorticoid-inducible kinase 1 (SGK1), a kinase genomically upregulated by several hormones including glucocorticoids and mineralocorticoids. SGK1 is activated by the serine/threonine kinase mammalian target of rapamycin (mTOR) isoform mTORC2. SGK1 knockout (sgk1–/– mice) impairs renal Na+ retention during salt depletion. The mTOR catalytic site inhibitor, PP242, but not mTORC1 inhibitor rapamycin, inhibits ENaC, decreases Na+ flux in isol...
Source: Nephrology Dialysis Transplantation - January 25, 2016 Category: Urology & Nephrology Authors: Lang, F., Pearce, D. Tags: REVIEWS - BASIC SCIENCE AND TRANSLATIONAL NEPHROLOGY Source Type: research

Comparison of the Safety and Effectiveness of Apixaban versus Warfarin in Patients with Severe Renal Impairment
ConclusionApixaban appears to be a reasonable alternative to warfarin in patients with severe renal impairment.This article is protected by copyright. All rights reserved.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - December 31, 2016 Category: Drugs & Pharmacology Authors: Brooke E. Stanton, Naomi S. Barasch, Katie B. Tellor Tags: Original Research Article Source Type: research

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