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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 pr...
Source: Seminars in Dialysis - July 11, 2017 Category: Urology & Nephrology Authors: Molnar AO, Sood MM Tags: Semin Dial 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 invest...
Source: Seminars in Dialysis - July 7, 2014 Category: Urology & Nephrology Authors: Herrington W, Haynes R, Staplin N, Emberson J, Baigent C, Landray M Tags: Semin Dial Source Type: research

The use of non-vitamin K oral anticoagulants in dialysis patients-A systematic review
This study investigated the available evidence for the use of NOACs in dialysis patients. Online databases were systematically searched for eligible studies including pharmacokinetic (PK) studies, cohort studies, and randomized control trials (RCTs) comparing NOAC with vitamin K antagonist (VKA) or no anticoagulant treatment. Newcastle Ottawa Scale and Cochrane Risk of bias tool were used for quality assessment. Twenty studies were identified (nine PK studies, two RCTs, and nine cohort studies). Most of the studies investigated apixaban or rivaroxaban. In dialysis patients, less accumulation was reported with apixaban and ...
Source: Seminars in Dialysis - May 27, 2022 Category: Urology & Nephrology Authors: Agitha Chandrasegaram Christian Daugaard Peters Source Type: research

Incidence and risk factors of cognitive dysfunction in hemodialysis patients: A systematic review and meta-analysis
CONCLUSIONS: The most important risk factors for cognitive dysfunction associated with hemodialysis might be female gender, old age, diabetes, and stroke. Close attention should be paid to such patients for early prevention.PMID:37592399 | DOI:10.1111/sdi.13171
Source: Seminars in Dialysis - August 18, 2023 Category: Urology & Nephrology Authors: Jun Liu Kehong Chen Jia Chen Lili Fu Weiwei Zhang Jing Lin Jingfang Wan Source Type: research

Blood Pressure Recordings During Hemodialysis Access Interventions: Implications for Acute Management.
Abstract A retrospective study evaluating the pattern of blood pressure and its related complications before, during, and after percutaneous hemodialysis interventions was performed in patients presenting with asymptomatic hypertension. Hemodialysis patients undergoing percutaneous interventions including tunneled hemodialysis catheter insertion, percutaneous balloon angioplasty and thrombectomy procedure, and stage II hypertension (systolic blood pressure ≥160 mmHg) were included in this analysis. Blood pressure medications were not used while midazolam and fentanyl were routinely administered. Patients were f...
Source: Seminars in Dialysis - March 28, 2013 Category: Urology & Nephrology Authors: Asif A, Castro H, Waheed AA, Kumar V, Haqqie SS, Siskin G, Mathew RO, Mason D, Vachharajani T, Nayer A, Merrill D, Akmal MU, Salman L Tags: Semin Dial 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 clinic...
Source: Seminars in Dialysis - January 1, 2014 Category: Urology & Nephrology Authors: Krüger T, Floege J Tags: Semin Dial Source Type: research

Clopidogrel Use in End-Stage Kidney Disease.
In conclusion, current evidence suggests that ESKD patients may not derive the same benefits from clopidogrel therapy as the general population and this therapy may be associated with harm. Properly designed observational studies and randomized controlled trials are needed to establish the role of clopidogrel in patients with ESKD, the use of platelet assays to tailor therapy, and the role of other antiplatelet agents such as prasugrel or ticagrelor in patients who exhibit high on-treatment residual platelet reactivity. PMID: 25476742 [PubMed - as supplied by publisher]
Source: Seminars in Dialysis - December 5, 2014 Category: Urology & Nephrology Authors: Tanios BY, Itani HS, Zimmerman DL Tags: Semin Dial Source Type: research

The physical deterioration of dialysis patients-Ignored, ill-reported, and ill-treated.
Abstract The progressive physical deterioration of dialysis patients is apparent to all who are involved in their care. Exercise can help stem this decline, yet exercise uptake in chronic and end-stage kidney disease is low. The involvement of exercise professionals has been shown to significantly increase patients' physical function and improve their quality of life. However, exercise professionals are scarce in renal programs, far less than dietetic and social work services. A review of 10 years of renal exercise publications in the physical therapy and rehabilitation literature found that only 0.4% (7 out of a ...
Source: Seminars in Dialysis - June 5, 2017 Category: Urology & Nephrology Authors: Bennett PN, Capdarest-Arest N, Parker K Tags: Semin Dial Source Type: research

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