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Specialty: Urology & Nephrology
Condition: Bleeding

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Total 71 results found since Jan 2013.

Warfarin Use, Stroke, and Bleeding Risk among Pre-Existing Atrial Fibrillation US Veterans Transitioning to Dialysis
In this study, we validated risk scores for stroke and bleeding in this population and assessed risk of stroke and bleeding among warfarin users compared to nonusers.Methods: We utilized a cohort of 28,620 pre-dialysis US veterans transitioning to hemodialysis between October 2007 and March 2015. Incident rates for the risks of stroke and bleeding were ascertained based upon CHA2DS2-VASc or HAS-BLED scores, respectively. A propensity score-based competing risk analysis was used to assess risk of stroke and bleeding.Findings: The mean age of our cohort was 77 ± 9 years, and the median CHA2DS2-VASc and HAS-BLED scores were ...
Source: Nephron - February 4, 2022 Category: Urology & Nephrology Source Type: research

Antiplatelet therapy for preventing stroke in patients with chronic kidney disease.
Abstract Chronic kidney disease (CKD), defined as reduced glomerular filtration rate and/or proteinuria, is a serious worldwide health problem. The incidence and prevalence of CKD are increasing with age, and patients with CKD are a population at very high risk for developing stroke. CKD may increase the risk for incident stroke independent of conventional stroke risk factors. A common pathological process including anemia, homocysteine, nitric oxide, oxidative stress, inflammation, and conditions promoting coagulation may be related to the development of stroke in the course of CKD. CKD can also serve as a marker...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Kim SJ, Bang OY Tags: Contrib Nephrol Source Type: research

Stroke in patients with chronic kidney disease & #8230;: How do we approach and manage it ?
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - May 3, 2017 Category: Urology & Nephrology Authors: S Nayak-Rao MP Shenoy Source Type: research

Preventing stroke and systemic embolism in renal patients with atrial fibrillation: focus on anticoagulation.
Abstract Chronic kidney disease and atrial fibrillation (AF) commonly coexist, and data suggest that renal patients have AF rates in excess of double that encountered in the general population. These patients are at increased risk of stroke, regardless of the presence or absence of AF. Furthermore, a lower GFR causes increased thromboembolic risk in patients with AF - independent of other risk factors. The dilemma facing clinicians treating this cohort of patients is that renal insufficiency confers both a thromboembolic and a bleeding risk. Renal disease also commonly coexists with other risk factors for stroke a...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Ahmad Y, Lip GY Tags: Contrib Nephrol Source Type: research

Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report
Publication date: Available online 21 September 2017 Source:American Journal of Kidney Diseases Author(s): Vinod K. Bansal, Charles A. Herzog, Mark J. Sarnak, Michael J. Choi, Ravindra Mehta, Bernard G. Jaar, Michael V. Rocco, Holly Kramer Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as...
Source: American Journal of Kidney Diseases - September 21, 2017 Category: Urology & Nephrology Source Type: research

Warfarin Use And the Risk Of Stroke, Bleeding, And Mortality In Older Adults On Dialysis With Incident Atrial Fibrillation
ConclusionOlder ESRD patients with AF who were treated with warfarin had a no difference in stroke risk, lower mortality risk, but increased major bleeding risk. The bleeding risk associated with warfarin was greater among women than men. The risk/benefit ratio of warfarin may be less favorable among older women.
Source: Nephrology - December 1, 2017 Category: Urology & Nephrology Authors: Jingwen Tan, Sunjae Bae, Jodi B. Segal, Junya Zhu, G. Caleb Alexander, Dorry L. Segev, Mara McAdams ‐DeMarco Tags: Original Article Source Type: research

Atrial Fibrillation and Warfarin Use in Haemodialysis Patients: An Individualized Holistic Approach is Important in Stroke Prevention
Abstract Incidence and prevalence of Atrial Fibrillation (AF) is higher in hemodialysis (HD) population than general population. AF is associated with higher morbidity and mortality than sinus rhythm in this population. The purpose of this review is to summarize all available evidence regarding use of warfarin in HD patients with AF for stroke prevention. The enormous heterogeneity of available studies does not allow pooling of the data in the form of meta‐analysis or systematic review. Current evidence regarding use of warfarin for AF in terms of risk benefit ratio in this population is limited and conflicting. Randomiz...
Source: Nephrology - March 25, 2013 Category: Urology & Nephrology Authors: Zaw Thet, Eswari Vilayur Tags: Review Article Source Type: research

Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Conclusions In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range.
Source: Nephrology Dialysis Transplantation - February 23, 2015 Category: Urology & Nephrology Authors: Genovesi, S., Rossi, E., Gallieni, M., Stella, A., Badiali, F., Conte, F., Pasquali, S., Bertoli, S., Ondei, P., Bonforte, G., Pozzi, C., Rebora, P., Valsecchi, M. G., Santoro, A. Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research

Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease
Background: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain.Summary: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA. Limited data fr...
Source: Cardiorenal Medicine - April 26, 2017 Category: Urology & Nephrology Source Type: research

Increased Incident Ischemic Stroke Risk in Advanced Kidney Disease: A Large-Scale Real-World Data Study.
CONCLUSION: Although we found that OAC use was effective and recommended for patients with AF, advanced kidney disease is still an independent risk factor for IS/SE, even in patients taking OAC. Physicians should be aware of this risk and strictly control modifiable risk factors, regardless of OAC use. PMID: 32726780 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - July 28, 2020 Category: Urology & Nephrology Authors: Maeda T, Nishi T, Funakoshi S, Tada K, Tsuji M, Satoh A, Kawazoe M, Yoshimura C, Arima H Tags: Am J Nephrol Source Type: research

Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
This interesting study of hemodialysis patients on oral anticoagulation for atrial fibrillation showed that although their overall mortality was high – it was not associated with warfarin.  In fact, warfarin was associated with better survival and antiplatelet agents increased overall mortality. . : The intersection of risk and benefit: is warfarin anticoagulation suitable for atrial fibrillation in patients on hemodialysis? Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease: A Systematic Review and Meta-analysis Stroke and Bleeding in Atrial Fib...
Source: Nephrology Now - March 18, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Source Type: research

Anticoagulation therapy: Balancing the risks of stroke and bleeding in CKD
Nature Reviews Nephrology 11, 200 (2015). doi:10.1038/nrneph.2015.14 Authors: Arman Qamar & Deepak L. Bhatt Whether anticoagulation with warfarin is safe and reduces risk of stroke in patients with atrial fibrillation and chronic kidney disease is unclear. A recent observational study shows a net clinical benefit of warfarin—without increased risk of bleeding—in this population, including in patients on dialysis.
Source: Nature Reviews Nephrology - February 10, 2015 Category: Urology & Nephrology Authors: Arman QamarDeepak L. Bhatt Tags: News and Views Source Type: research

Cardiologists' and nephrologists' management of atrial fibrillation in hemodialysis patients 
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CONCLUSION: Cardiologists were more likely to prescribe anticoagulant therapy for AF in the HD population compared to nephrologists, regardless of patient stroke or bleeding risk.
. PMID: 31496513 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - September 8, 2019 Category: Urology & Nephrology Authors: Marcus L, Mackeigan L, Leblanc K, Orlov D, Mitsakakis N, Austin Z, Jassal SV, Battistella M Tags: Clin Nephrol Source Type: research

Outcomes After Warfarin Initiation in a Cohort of Hemodialysis Patients With Newly Diagnosed Atrial Fibrillation
Conclusions In hemodialysis patients with incident AF, warfarin use was marginally associated with reduced risk of ischemic stroke, and there was a signal toward reduced mortality in as-treated analyses. These results support clinical equipoise regarding the use of warfarin in hemodialysis patients and underscore the need for randomized trials to fill this evidence gap.
Source: American Journal of Kidney Diseases - July 9, 2015 Category: Urology & Nephrology Source Type: research

Evaluation of clinical outcomes among nonvalvular atrial fibrillation patients treated with rivaroxaban or warfarin, stratified by renal  function
.
CONCLUSION: Rivaroxaban-treated NVAF patients with diagnosed renal dysfunction had a significantly lower stroke rate compared to warfarin-treated patients. Regardless of renal dysfunction diagnoses, rivaroxaban users had lower thromboembolic event rates compared to warfarin users, and a similar rate of major bleeding. eCrCl-based analysis was limited by a small sample size. PMID: 29231162 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - December 12, 2017 Category: Urology & Nephrology Authors: Weir MR, Haskell L, Berger JS, Ashton V, Laliberté F, Crivera C, Brown K, Lefebvre P, Schein J Tags: Clin Nephrol Source Type: research