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Modulation of stroke risk in chronic kidney disease
Stroke is the second most common cause of death and the leading cause of neurological disability worldwide, with huge economic costs and tragic human consequences. Both chronic kidney disease (CKD) and end-stage kidney disease are associated with a significantly increased risk of stroke. However, to date this has generated far less interest compared with the better-recognized links between cardiac and renal disease. Common risk factors for stroke, such as hypertension, hypercholesterolaemia, smoking and atrial fibrillation, are shared with the general population but are more prevalent in renal patients. In addition, factor...
Source: CKJ: Clinical Kidney Journal - January 20, 2016 Category: Urology & Nephrology Authors: Arnold, J., Sims, D., Ferro, C. J. Tags: CARDIOVASCULAR NEPHROLOGY Source Type: research

Risk Factors for Stroke in People with End-Stage Kidney Disease: A Cohort Study
Conclusions: These findings could be used to establish reliable estimates of the risk of stroke in people with ESKD and identify those who are most likely to benefit from preventive treatments.Cerebrovasc Dis 2016;42:428-438
Source: Cerebrovascular Diseases - August 9, 2016 Category: Neurology Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

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

Mechanisms of Stroke in Patients with Chronic Kidney Disease.
Abstract BACKGROUND: Given the increasing worldwide prevalence of chronic kidney disease (CKD), it is critical to decrease the associated risk of debilitating vascular complications, including stroke, congestive heart failure, myocardial infarction, and peripheral vascular disease. Treatment options for reducing the risk of all subtypes of stroke in patients with CKD remain limited. For patients with end-stage kidney disease (ESKD), novel applications of noninvasive imaging may help personalize the type of dialysis and dialysis prescription for patients at high-risk. SUMMARY: This manuscript reviews the heigh...
Source: American Journal of Nephrology - August 27, 2019 Category: Urology & Nephrology Authors: Ghoshal S, Freedman BI Tags: Am J Nephrol Source Type: research

Impact of atrial fibrillation on the risk of ischemic stroke in patients on hemodialysis: BOREAS-HD3 Study
ConclusionPresent analyses using comprehensive adjustment for multiple confounders, including prior history of ischemic stroke, indicated that AF independently increases the risk of new-onset of ischemic stroke by more than twofold in Japanese HD patients.
Source: Clinical and Experimental Nephrology - November 18, 2020 Category: Urology & Nephrology Source Type: research

Low serum fetuin A levels and incident stroke in patients with maintenance haemodialysis
ConclusionsFetuin A deficiency is associated with a higher risk of incident stroke among prevalent HD patients.
Source: European Journal of Clinical Investigation - February 19, 2013 Category: Journals (General) Authors: Hung‐Yuan Chen, Yen‐Ling Chiu, Shih‐Ping Hsu, Mei‐Fen Pai, Ju‐Yeh Yang, Yu‐Sen Peng Tags: Original Article Source Type: research

The Impact of Acute Kidney Injury on the Long-term Risk of Stroke Kidney in Cardiovascular Disease
Conclusions The patients who recovered from AKI had a higher incidence of developing incident stroke and mortality than the patients without AKI, and the impact was similar to diabetes. Our results suggest that a public health initiative is needed to enhance postdischarge follow-up of renal function and to control the subsequent incidence of stroke among patients who recover from AKI after dialysis.
Source: JAHA:Journal of the American Heart Association - July 15, 2014 Category: Cardiology Authors: Wu, V.-C., Wu, P.-C., Wu, C.-H., Huang, T.-M., Chang, C.-H., Tsai, P.-R., Ko, W.-J., Chen, L., Wang, C.-Y., Chu, T.-S., Wu, K.-D., The National Taiwan University Study Group on Acute Renal Failure (NSARF) Group Tags: Kidney in Cardiovascular Disease Source Type: research

Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease: A 13-Year Population-Based Cohort Study
Abstract: Research information on the risk of stroke in patients with dialysis-dependent end-stage renal disease (ESRD) who have undergone parathyroidectomy (PTX) is scant. We used a nationwide health insurance claims database to select all patients with dialysis-dependent ESRD age 18 years and older for the study population. Of the patients with ESRD, we selected 1083 patients who had undergone PTX between 1998 and 2006 as the PTX group and frequency-matched 1083 patients with ESRD by sex, age, years since the disease diagnosis, and the year of undergoing PTX as the non-PTX group. We used a multivariate Cox proportional h...
Source: Medicine - June 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Impact of dialysis modality on the survival of patients with end-stage renal disease and prior stroke
Conclusions PD was associated with overall poorer survival among patients with diabetes, ESRD and prior stroke and with similar overall survival among patients with ESRD and prior stroke, but without diabetes, compared with HD.
Source: International Urology and Nephrology - November 11, 2015 Category: Urology & Nephrology Source Type: research

Risks of Death and Stroke in Patients Undergoing Hemodialysis With New-Onset Atrial Fibrillation: A Competing-Risk Analysis of a Nationwide Cohort.
CONCLUSIONS: -The risk of stroke was only modestly higher in patients undergoing hemodialysis with new-onset AF than in those without AF, and it became insignificant when accounting for the competing risk of in-hospital death. PMID: 26680239 [PubMed - as supplied by publisher]
Source: Circulation - December 17, 2015 Category: Cardiology Authors: Shih CJ, Ou SM, Chao PW, Kuo SC, Lee YJ, Yang CY, Tarng DC, Lin CC, Huang PH, Li SY, Chen YT Tags: Circulation Source Type: research

Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research

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

Association of Dyskalemias with Ischemic Stroke in Advanced Chronic Kidney Disease Patients Transitioning to Dialysis
Conclusion: In patients with advanced CKD, hypokalemia (chronic exposure) was associated with a higher risk of ischemic stroke, whereas hyperkalemia (acute exposure) was associated with a lower risk of ischemic stroke. Further studies in this population are needed to explore the mechanisms underlying these associations.Am J Nephrol
Source: American Journal of Nephrology - July 21, 2021 Category: Neurology Source Type: research