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Warfarin Use and Risk of Stroke in Patients With Atrial Fibrillation Undergoing Hemodialysis: A Meta-Analysis
Abstract: In spite of the substantial burden of atrial fibrillation and associated elevated ischemic stroke risk in patients undergoing hemodialysis, the role of warfarin in these high-risk patients remains uncertain. Our objective was to clarify the association between warfarin use and risk of stroke for patients with atrial fibrillation undergoing dialysis. PubMed and Embase from January 1966 to January 2015 were searched to identify relevant studies. Inclusion criteria were cohort studies, patients with atrial fibrillation undergoing hemodialysis, and reported quantitative estimates of the multivariate adjusted relativ...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observ Studies in Epidemiology Source Type: research

Effectiveness and Safety of Warfarin in Dialysis Patients With Atrial Fibrillation: A Meta-Analysis of Observational Studies
The objective of this study was to assess the effectiveness and safety of warfarin use in patients with AF undergoing dialysis. Three databases PubMed, EMBASE, and OVID were searched from their inception to August 2015. Observational studies which assessed the ischemic stroke or bleeding risk of warfarin use in dialysis patients with AF were included. Two reviewers independently extracted data and assessed methodological quality based on the Newcastle–Ottawa Scale score. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model and heterogeneity was assessed based...
Source: Medicine - December 1, 2015 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research

Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines.
Authors: Młodawska E, Tomaszuk-Kazberuk A, Łopatowska P, Musiał WJ, Małyszko J Abstract Atrial fibrillation (AF) frequently occurs in patients with chronic kidney disease (CKD), and the rate reaches even 30% in patients with end-stage renal disease (ESRD). Patients with AF and CKD have a significantly higher risk of thrombotic complications, particularly ischemic stroke, and at the same time, a higher bleeding risk (proportionally to the grade of renal failure). In addition, AF and CKD share a number of comorbidities and risk factors, which results in increased mortality rates. Moreover, disturbances in hemosta...
Source: Polskie Archiwum Medycyny Wewnetrznej - June 2, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

End-Stage Renal Disease, Nonvalvular Atrial Fibrillation, and the Warfarin Dilemma
There are more than 660,000 Americans with kidney failure and nearly 470,000 on dialysis.1 Of these, estimates of nonvalvular atrial fibrillation (NVAF) approach 20%.2 Atrial fibrillation nearly doubles the anticipated mortality and increases the stroke risk by approximately six-fold in these patients. The intersection between end-stage renal disease (ESRD) and NVAF is complicated and not easily parsed. Atrial fibrillation likely increases the rate of progression to ESRD in patients with underlying chronic kidney disease (CKD).
Source: Mayo Clinic Proceedings - May 31, 2020 Category: Internal Medicine Authors: Robert D. McBane Tags: Editorial Source Type: research