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Specialty: Urology & Nephrology
Condition: Bleeding

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Total 71 results found since Jan 2013.

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

Apixaban versus No Anticoagulation in Patients Undergoing Long-Term Dialysis with Incident Atrial Fibrillation.
CONCLUSIONS: In patients with kidney failure and nonvalvular atrial fibrillation, treatment with apixaban was not associated with a lower incidence of new stroke, transient ischemic attack, or systemic thromboembolism but was associated with a higher incidence of fatal or intracranial bleeding. PMID: 32444398 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 21, 2020 Category: Urology & Nephrology Authors: Mavrakanas TA, Garlo K, Charytan DM Tags: Clin J Am Soc Nephrol Source Type: research

Readmissions after Acute Kidney Injury during Left Ventricular Assist Device Implantation Hospitalization.
CONCLUSION: AKI-D was associated with highest -30-day readmission risk, possibly related to negatively synergistic effects of LVAD, kidney dysfunction, and dialysis related factors on infection and GI bleeding risks. AKI alone was not associated with increased readmission risk. PMID: 31962311 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - January 20, 2020 Category: Urology & Nephrology Authors: Walther CP, Winkelmayer WC, Deswal A, Niu J, Navaneethan SD Tags: Am J Nephrol 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

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

Duration of Dual Antiplatelet Therapy in Patients with CKD and Drug-Eluting Stents: A Meta-Analysis.
CONCLUSIONS: Short DAPT does not appear to be inferior to longer DAPT in patients with CKD and drug-eluting stents. Because of imprecision in estimates (few events and wide confidence intervals), no definite conclusions can be drawn with respect to stent thrombosis. PMID: 31010936 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - April 21, 2019 Category: Urology & Nephrology Authors: Mavrakanas TA, Chatzizisis YS, Gariani K, Kereiakes DJ, Gargiulo G, Helft G, Gilard M, Feres F, Costa RA, Morice MC, Georges JL, Valgimigli M, Bhatt DL, Mauri L, Charytan DM Tags: Clin J Am Soc Nephrol Source Type: research

Recent evidence for direct oral anticoagulants in chronic kidney disease
Purpose of review The direct oral anticoagulants (DOACs) have emerged as an effective and safe alternative to vitamin K antagonists (VKAs) for stroke and venous thromboembolism (VTE) prevention. However, patients with chronic kidney disease (CKD) experience an increase in the risk of both thromboembolism and bleeding, and the risk–benefit profile of DOACs, particularly in advanced CKD remains a source of ongoing debate. This review summarizes the recent evidence on the effects of DOACs in CKD across a range of clinical indications including newly emerging indications. Recent findings Data on early-to-moderate stage ...
Source: Current Opinion in Nephrology and Hypertension - April 4, 2019 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Demystifying the Benefits and Harms of Anticoagulation for Atrial Fibrillation in Chronic Kidney Disease.
This article aims to present a contemporary literature review of the benefits versus harms of anticoagulation in atrial fibrillation for patients with CKD stages 3, 4, 5, and 5 on dialysis. Although unanswered questions and areas of clinical equipoise remain, this piece serves to assist physicians in interpreting the complex body of literature and applying it to their clinical care. PMID: 30593489 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - December 28, 2018 Category: Urology & Nephrology Authors: Garlo KG, Steele DJR, Nigwekar SU, Chan KE Tags: Clin J Am Soc Nephrol Source Type: research

Which anticoagulants should be used for stroke prevention in non-valvular atrial fibrillation and severe chronic kidney disease?
Purpose of review Non-valvular atrial fibrillation is common in patients with severe chronic kidney disease (CKD) and historically patients have been treated with vitamin K antagonists (VKA). However, these agents have questionable efficacy and are associated with increased bleeding risk. Non-vitamin K oral anticoagulants (NOAC) have advantages over VKA in early stage CKD. In this review, we sought to establish evidence for best practice in patients with severe CKD (creatinine clearance
Source: Current Opinion in Nephrology and Hypertension - October 5, 2018 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Risks and Benefits of Direct Oral Anticoagulants across the Spectrum of GFR among Incident and Prevalent Patients with Atrial Fibrillation.
CONCLUSIONS: In a large health care system, patients with eGFR<60 ml/min per 1.73 m2 who took direct oral anticoagulants for atrial fibrillation had slightly higher risk of bleeding compared with those on warfarin, but similar benefits from prevention of ischemic stroke. PMID: 30002224 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - July 12, 2018 Category: Urology & Nephrology Authors: Shin JI, Secora A, Alexander GC, Inker LA, Coresh J, Chang AR, Grams ME Tags: Clin J Am Soc Nephrol Source Type: research

A case of cerebral infarction during a hemodialysis procedure successfully treated with recombinant tissue plasminogen activator
We report a case of a 75-year-old HD patient who presented with sudden aphasia during HD treatment. She was brought to the hospital for treatment for infarction. Following thrombolytic therapy, we achieved re-opening without complications. To our knowledge, no report has been published describing the patients who had a stroke during a maintenance HD session and were treated with r-tPA successfully. Although the number of HD patients treated with r-tPA is small and requires further investigation, thrombolytic therapy can be an alternative option. After weighing the risks and benefits and assessing each patient carefully, th...
Source: CEN Case Reports - June 12, 2018 Category: Urology & Nephrology Source Type: research

Safety and effectiveness of rivaroxaban and warfarin in moderate-to-advanced CKD: real world data.
CONCLUSION: Rivaroxaban seems a safe and effective therapeutic option in CKD stage 3b-4 patients. However, future randomized controlled trials are needed to definitively establish the role of rivaroxaban in CKD patients. PMID: 29882198 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - June 7, 2018 Category: Urology & Nephrology Authors: Di Lullo L, Tripepi G, Ronco C, De Pascalis A, Barbera V, Granata A, Russo D, Di Iorio BR, Paoletti E, Ravera M, Fusaro M, Bellasi A Tags: J Nephrol Source Type: research

Clinical Pharmacology of Oral Anticoagulants in Patients with Kidney Disease.
This article summarizes the clinical pharmacology of these drugs and identifies knowledge gaps in the literature related to their use. PMID: 29802125 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 25, 2018 Category: Urology & Nephrology Authors: Jain N, Reilly RF Tags: Clin J Am Soc Nephrol Source Type: research

Atrial fibrillation in dialysis patients: is there a place for non-vitamin K antagonist oral anticoagulants?
AbstractAtrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin. Nevertheless according to ESC guidelines, NOACs are not recommended in p...
Source: International Urology and Nephrology - May 21, 2018 Category: Urology & Nephrology Source Type: research

Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.
We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research