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Predicting in a predicament: Stroke and hemorrhage risk prediction in dialysis patients with atrial fibrillation
Abstract Whether to anticoagulate dialysis patients with atrial fibrillation is a common clinical dilemma with limited high‐quality data to inform decision‐making. While the efficacy and safety of anticoagulation for stroke prevention in dialysis patients with atrial fibrillation has long been debated and remains unclear, the more upstream issue of stroke risk assessment from atrial fibrillation has received relatively little attention. In the general population, a handful of risk scores to help predict stroke and hemorrhage risk in the setting of atrial fibrillation are widely validated and applied in clinical practic...
Source: Seminars In Dialysis - July 1, 2017 Category: Hematology Authors: Amber O. Molnar, Manish M. Sood Tags: REVIEW ARTICLE Source Type: research

Evidence for the Prevention and Treatment of Stroke in Dialysis Patients
Abstract The risks of both ischemic and hemorrhagic stroke are particularly high in dialysis patients of any age and outcomes are poor. It is therefore important to identify strategies that safely minimize stroke risk in this population. Observational studies have been unable to clarify the relative importance of traditional stroke risk factors such as blood pressure and cholesterol in those on dialysis, and are affected by biases that usually make them an inappropriate source of data on which to base therapeutic decisions. Well‐conducted randomized trials are not susceptible to such biases and can reliably investigate t...
Source: Seminars In Dialysis - May 1, 2014 Category: Hematology Authors: William Herrington, Richard Haynes, Natalie Staplin, Jonathan Emberson, Colin Baigent, Martin Landray Tags: Review Source Type: research

Vitamin K Antagonists: Beyond Bleeding
Abstract Warfarin is the most widely used oral anticoagulant in clinical use today. Indications range from prosthetic valve replacement to recurrent thromboembolic events due to antiphospholipid syndrome. In hemodialysis (HD) patients, warfarin use is even more frequent than in the nonrenal population due to increased cardiovascular comorbidities. The use of warfarin in dialysis patients with atrial fibrillation requires particular caution because side effects may outweigh the assumed benefit of reduced stroke rates. Besides increased bleeding risk, coumarins exert side effects which are not in the focus of clinical routin...
Source: Seminars In Dialysis - January 9, 2014 Category: Hematology Authors: Thilo Krüger, Jürgen Floege Tags: Review Source Type: research