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Condition: Atrial Fibrillation
Procedure: Dialysis

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Total 370 results found since Jan 2013.

Dabigatran treatment simulation in patients undergoing maintenance haemodialysis.
This study simulated the dose-exposure relationship of dabigatran in patients undergoing haemodialysis. Dabigatran exposure was modelled at once- and twice-daily doses of 75 mg, 110 mg and 150 mg and at variations in non-renal clearance and dialysis settings. Resultant dose exposure (area under the curve [AUC]) was compared with values simulated from typical patients in the RE-LY® trial (based on a previously characterised pharmacometric model). In this simulation, all twice-daily dosages resulted in exposures above those simulated from typical RE-LY patients (1.5- to 3.3-fold increase in AUC) and thus may not be optimal ...
Source: Thrombosis and Haemostasis - October 15, 2015 Category: Hematology Authors: Liesenfeld KH, Clemens A, Kreuzer J, Brueckmann M, Schulze F Tags: Thromb Haemost 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

The Effect of Cardiopulmonary Bypass on Dabigatran Levels
DABIGATRAN IS a novel anticoagulant that is licensed for use for the prevention of stroke in the presence of atrial fibrillation. Its use has expanded rapidly in New Zealand, primarily due to there being no requirement for routine monitoring of its effect, as there is for warfarin. There are case reports in the literature describing management of patients coming for urgent cardiac surgery, which revolve mainly around the use of dialysis and massive transfusion of clotting factors to manage the bleeding associated with surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 31, 2015 Category: Anesthesiology Authors: Kelly Byrne Tags: CASE REPORT Source Type: research

Influence of apixaban on antifactor Xa levels in a patient with acute kidney injury.
CONCLUSION: A 70-year-old man with new-onset nonvalvular atrial fibrillation and receiving apixaban discontinued this therapy and was given heparin instead due to acute kidney injury. His heparin dosage was successfully adjusted based on antifactor Xa levels and aPPTs. PMID: 27045068 [PubMed - in process]
Source: American Journal of Health-System Pharmacy : AJHP - April 7, 2016 Category: Drugs & Pharmacology Authors: Wendte J, Voss G, VanOverschelde B Tags: Am J Health Syst Pharm Source Type: research

Direct oral anticoagulant associated bleeding.
Abstract Direct oral anticoagulants (DOAC) are recommended for stroke prevention in atrial fibrillation and for the treatment of venous thromboembolism. However, they are associated with hemorrhagic complications. Management of DOAC-induced bleeding remains challenging. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. Therapeutic options also include antidotes: idarucizumab, antidote for dabigatran, has been approved for use whereas andexanet alpha, antidote for anti-Xa agents, and aripazine, antidote for all DOAC, are under development. Other ...
Source: Journal des Maladies Vasculaires - June 9, 2016 Category: Cardiology Authors: Godier A, Martin AC, Rosencher N, Susen S Tags: J Mal Vasc Source Type: research

Atrial Fibrillation and Chronic Kidney Disease Requiring Hemodialysis – Does Warfarin Therapy Improve the Risks of this Lethal Combination?
Warfarin therapy for stroke prevention is recommended for patients with AF, but its value in patients with chronic kidney disease on HD is unknown.
Source: International Journal of Cardiology - July 7, 2016 Category: Cardiology Authors: Lohit Garg, Charity Chen, David E. Haines Source Type: research

IMAGES IN CLINICAL MEDICINE Lindsay ’s Nails in Chronic Kidney Disease
This image says it all.  An interesting nail bed finding in CKD. : Intestinal radiopacities in chronic renal failure Case Records of the Massachusetts General Hospital. Case 35-2015: A 72-Year-Old Woman with Proteinuria and a Kidney Mass. Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Source Type: research

The Effect of Cardiopulmonary Bypass on Dabigatran Levels
DABIGATRAN IS a novel anticoagulant that is licensed for use for the prevention of stroke in the presence of atrial fibrillation. Its use has expanded rapidly in New Zealand, primarily due to there being no requirement for routine monitoring of its effect, as there is for warfarin. There are case reports in the literature describing management of patients coming for urgent cardiac surgery, which revolve mainly around the use of dialysis and massive transfusion of clotting factors to manage the bleeding associated with surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 30, 2015 Category: Anesthesiology Authors: Kelly Byrne Tags: CASE REPORT Source Type: research

Atrial fibrillation and chronic kidney disease requiring hemodialysis — Does warfarin therapy improve the risks of this lethal combination?
Warfarin therapy for stroke prevention is recommended for patients with AF, but its value in patients with chronic kidney disease on HD is unknown.
Source: International Journal of Cardiology - July 7, 2016 Category: Cardiology Authors: Lohit Garg, Charity Chen, David E. Haines Source Type: research

All bleeding stops — but does idarucizumab (Praxbind) make it stop faster?
3.5 out of 5 stars Persistent life-threatening hemorrhage after administration of idarucizumab. Alhashem HM et al. Am J Emerg Med 2016 June 30 [Epub ahead of print] Reference Dabigatran (Pradaxa) is a direct thrombin inhibitor approved for stroke and embolism prophylaxis in patients with non-valve-related atrial fibrillation. When it was first released in 2008, a major disincentive to widespread use was the lack of a reliable reversal agent to treat major bleeds, or to administer before necessary invasive procedures. In October 2015, the U.S. Food and Drug Administration approved idarucizumab (Praxbind), a monoclonal ant...
Source: The Poison Review - July 27, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical anticoagulant hemorrhage idarucizumab pradaxa praxbind reversal agent Source Type: news

Comparison of isoflurane and sevoflurane in cardiac surgery: a randomized non-inferiority comparative effectiveness trial.
CONCLUSION: Sevoflurane is non-inferior to isoflurane on a composite outcome of prolonged ICU stay and all-cause 30-day mortality. Sevoflurane is not superior to isoflurane on any other of the clinically important outcomes. This trial was registered at clinicaltrials.gov; NCT01477151. PMID: 27465213 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - July 26, 2016 Category: Anesthesiology Authors: Jones PM, Bainbridge D, Chu MW, Fernandes PS, Fox SA, Iglesias I, Kiaii B, Lavi R, Murkin JM Tags: Can J Anaesth Source Type: research

Patients' Characteristics Affect the Survival Benefit of Warfarin Treatment for Hemodialysis Patients with Atrial Fibrillation. A Historical Cohort Study
Background: Stroke prevention in dialysis-dependent patients with atrial fibrillation (AF) is an unresolved clinical dilemma. Indeed, no randomized controlled trial evaluating the efficacy and safety of oral anticoagulants in this population, has been conducted so far. Observational research on the use of warfarin in patients on dialysis has shown conflicting results. This uncertainty is mirrored by the wide variations in warfarin prescription patterns across centers. We sought to evaluate the association between the use of vitamin K antagonists (VKAs) and mortality among hemodialysis patient with AF and to assess potentia...
Source: American Journal of Nephrology - September 6, 2016 Category: Neurology Source Type: research

Comparison of isoflurane and sevoflurane in cardiac surgery: a randomized non-inferiority comparative effectiveness trial
ConclusionSevoflurane is non-inferior to isoflurane on a composite outcome of prolonged ICU stay and all-cause 30-day mortality. Sevoflurane is not superior to isoflurane on any other of the clinically important outcomes. This trial was registered at clinicaltrials.gov; NCT01477151.
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Dabigatran overdose: a case report of acute hepatitis. Extracorporeal treatment.
We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration. Although extracorporeal therapy has been suggested as a strategy for clearing dabigatran during acute bleeding, this approach may be useful in other dabigatran-related, life-threatening conditions, such as that described in this report. PMID: 27910004 [PubMed - as supplied by publisher]
Source: International Journal of Hematology - November 30, 2016 Category: Hematology Authors: Porru M, Mameli A, Cianchetti ME, Musu M, Schirru P, Ruberto MF, Barcellona D, Marongiu F Tags: Int J Hematol Source Type: research

Antiplatelet agents in hemodialysis.
In conclusion, since CRF patients are one of the groups at highest risk for atherosclerotic events, it could be reasonable to use aspirin in HD patients. However, the bleeding risk in HD patients needs to be strongly evaluated, especially before starting dual AA treatment. PMID: 27928736 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - December 7, 2016 Category: Urology & Nephrology Authors: Migliori M, Cantaluppi V, Scatena A, Panichi V Tags: J Nephrol Source Type: research