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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

Warfarin in nonvalvular atrial fibrillation-Time for a change?
Abstract Warfarin is the most commonly prescribed anticoagulant in hemodialysis (HD) patients with nonvalvular atrial fibrillation (NVAF). Recent trends show that Nephrologists are increasingly prescribing novel oral anticoagulants, despite the fact that no randomized clinical trials have been conducted in dialysis patients. Difficulties maintaining international normalized ratio in the therapeutic range, increased risk of intracranial hemorrhage and concerns regarding warfarin-induced vascular calcification and calciphylaxis may be responsible. Anticoagulation quality is poor in HD patients. A variety of factors ...
Source: Seminars in Dialysis - June 16, 2019 Category: Urology & Nephrology Authors: Reilly RF, Jain N Tags: Semin Dial Source Type: research

A brief review of intradialytic hypotension with a focus on survival.
Abstract Intradialytic hypotension (IDH), a common complication of ultrafiltration during hemodialysis therapy, is associated with high mortality and morbidity. IDH, defined as a nadir systolic blood pressure of less than 90 mm Hg on more than 30% of treatments, is a relevant definition and is correlated with mortality. Risk factors for IDH include patient demographics, anti-hypertensive medication use, larger interdialytic weight gain, and dialysis prescription features as dialysate sodium, high ultrafiltration rate, and dialysate temperature. A high frequency of IDH events carries a substantial death risk. An ul...
Source: Seminars in Dialysis - June 29, 2017 Category: Urology & Nephrology Authors: Chou JA, Kalantar-Zadeh K, Mathew AT 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

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

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