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Remote Ischemic Preconditioning Reduces Cardiac Troponin I Release in Cardiac Surgery: A Meta-Analysis
Conclusions: Current evidence suggests that RIPC reduces cardiac troponin I release in patients undergoing cardiac surgery. The clinical significance of these observations merits further investigation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 7, 2013 Category: Anesthesiology Authors: Lijing Yang, Guyan Wang, Yingjie Du, Bingyang Ji, Zhe Zheng Tags: Original Articles Source Type: research

Evaluating time in therapeutic range for hemodialysis patients taking warfarin.
In conclusion, this HD unit is not meeting the TTR goal established in the literature and patients are often subtherapeutic. Further studies to investigate ways to improve TTR are warranted. Ultimately, a prospective study evaluating the safety and efficacy of warfarin in HD patients is needed. PMID: 25500296 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - December 15, 2014 Category: Urology & Nephrology Authors: Quinn LM, Richardson R, Cameron KJ, Battistella M Tags: Clin Nephrol Source Type: research

Pharmacokinetics, safety, and tolerability of edoxaban in end-stage renal disease subjects undergoing haemodialysis.
In conclusion, based on these single-dose PK data, a supplementary dose of edoxaban may not be required following a haemodialysis session. Importantly, haemodialysis is not an effective mechanism for removal of edoxaban from the blood. PMID: 25566930 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 8, 2015 Category: Hematology Authors: Parasrampuria DA, Marbury T, Matsushima N, Chen S, Wickremasingha PK, He L, Dishy V, Brown KS Tags: Thromb Haemost Source Type: research

Dabigatran overdose: case report of laboratory coagulation parameters and hemodialysis of an 85-year-old man
Dabigatran is an oral direct inhibitor indicated for stroke prevention in patients with atrial fibrillation. Unlike warfarin, dabigatran's observed therapeutic window and minimal drug-to-drug interaction suggest that laboratory test and dose adjustments are not necessary; nevertheless, circumstances of excessive anticoagulation, decreased kidney function, and instances of significant bleeding and thrombosis require laboratory assessment. In order to gather experience in the management of global [activated partial thromboplastin time (APTT) and thrombin time (TT) with extended endpoint] and specific [ecarin chromogenic assa...
Source: Blood Coagulation and Fibrinolysis - January 30, 2015 Category: Hematology Tags: Case Reports Source Type: research

Management of dabigatran-induced bleeding with continuous venovenous hemodialysis.
Abstract Dabigatran, a direct thrombin inhibitor, is increasingly used for stroke prevention in patients with non-valvular atrial fibrillation. Dabigatran has a stable pharmacokinetic profile with minimum drug interactions, and requires no routine laboratory evaluation to measure level of anticoagulation. This provides a huge advantage over warfarin, and has the potential to improve patient compliance. The disadvantages of dabigatran are the lack of a reversal agent to counter dabigatran-related bleeding and the absence of a widely available laboratory test that can quantify the extent of coagulopathy in dabigatr...
Source: International Journal of Hematology - January 30, 2015 Category: Hematology Authors: Paul S, Hamouda D, Prashar R, Mbaso C, Khan A, Ali A, Shah S, Assaly R Tags: Int J Hematol 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 Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation Use of phosphate-binding agents is associated with a lower risk of mortality
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Source Type: research

Dose-Finding Study of Rivaroxaban in Hemodialysis Patients
Conclusions A 10-mg dose of rivaroxaban in hemodialysis patients without residual kidney function results in drug exposure similar as published for 20mg in healthy volunteers. Rivaroxaban is not eliminated by dialysis. There is no accumulation after multiple daily dosing. The efficacy and safety of rivaroxaban in hemodialysis patients should be the subject of a large randomized trial.
Source: American Journal of Kidney Diseases - June 22, 2015 Category: Urology & Nephrology Source Type: research

Hemodialysis for the treatment of dabigatran‐associated bleeding: a case report and systematic review
ConclusionsIn patients with dabigatran associated bleeding, RRT appears to be effective in reducing dabigatran concentrations and in case reports this has been associated with a reduction in duration and/or severity of bleeding. However, a rebound in concentrations may be seen following withdrawal of RRT suggesting that a prolonged course of RRT may be more effective.This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - August 1, 2015 Category: Hematology Authors: Chatree Chai‐Adisaksopha, Christopher Hillis, Wendy Lim, Kochawan Boonyawat, Karen Moffat, Mark Crowther Tags: Original Article ‐ Clinical Haemostasis and Thrombosis Source Type: research

Hemodialysis for the treatment of dabigatran-associated bleeding: a case report and systematic review.
CONCLUSIONS: In patients with dabigatran associated bleeding, RRT appears to be effective in reducing dabigatran concentrations and in case reports this has been associated with a reduction in duration and/or severity of bleeding. However, a rebound in concentrations may be seen following withdrawal of RRT suggesting that a prolonged course of RRT may be more effective. This article is protected by copyright. All rights reserved. PMID: 26270886 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - August 13, 2015 Category: Hematology Authors: Chai-Adisaksopha C, Hillis C, Lim W, Boonyawat K, Moffat K, Crowther M Tags: J Thromb Haemost Source Type: research

Peri-procedural management of patients taking oral anticoagulants
This article will help guide physician to better provide peri-procedural management of oral anticoagulation therapy. : Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation Update in Nephrology: Evidence Published in 2010 Policy Statement of Canadian Society of Transplantation and Canadian Society of Nephrology on Organ Trafficking and Transplant Tourism
Source: Nephrology Now - September 21, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: General Nephrology Review Source Type: research

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

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

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