• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

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

Cardiovascular and Stroke Risk in Japanese Hemodialysis Patients With Atrial Fibrillation
Abstract Atrial fibrillation is one of the most common arrhythmias in hemodialysis patients. We evaluated its clinical outcomes among hemodialysis patients with atrial fibrillation in Japan. Using data derived from the Japanese Dialysis Outcomes and Practice Patterns Study, we analyzed backgrounds and outcomes among hemodialysis patients with and without atrial fibrillation in Japan. Among 7002 hemodialysis patients, the prevalence of atrial fibrillation was 5.7% and the incidence was 0.2 per 100 patient‐years. Atrial fibrillation was independently associated with all‐cause mortality (hazard ratio, 1.32; 95% confidence...
Source: Therapeutic Apheresis and Dialysis - September 30, 2016 Category: Hematology Authors: Jumpei Hasegawa, Brian Bieber, Maria Larkina, Bruce M. Robinson, Sachiko Wakai, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Takashi Akiba Tags: Original Article 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

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

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 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

Antithrombotic therapy in end ‐stage renal disease
Abstract The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidn...
Source: Hemodialysis International - April 1, 2017 Category: Hematology Authors: Svetha Chunduri, Jon E. Folstad, Tushar J. Vachharajani Tags: Review Article Source Type: research

Effectiveness and safety of direct oral anticoagulants in patients with venous thromboembolism and creatinine clearance   & lt;  30 mL/min
AbstractThe few studies that compared direct oral anticoagulants (DOAC) vs. warfarin in the setting of advanced renal insufficiency have focused on patients with atrial fibrillation. The purpose of this observational, matched, cohort study of patients was to assess the effectiveness and safety of DOAC vs. warfarin for the treatment of venous thromboembolism (VTE) among patients with a creatinine clearance (CrCl)  <  30 mL/min. This observational, cohort study included patients with VTE and CrCl <  30 mL/min who were newly initiated on a DOAC or warfarin between January 1, 2016 and December 31, 2020. DOAC pati...
Source: Journal of Thrombosis and Thrombolysis - December 23, 2022 Category: Hematology Source Type: research