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Specialty: Urology & Nephrology
Condition: Bleeding

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Total 71 results found since Jan 2013.

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

Reply: Warfarin in patients on haemodialysis with atrial fibrillation—friend or foe?
Nature Reviews Nephrology 11, 450 (2015). doi:10.1038/nrneph.2015.103 Authors: Arman Qamar & Deepak L. Bhatt We would like to thank G. Schlieper and J. Floege for their comments on our News & Views article (Anticoagulation therapy: Balancing the risks of stroke and bleeding in CKD. Nat. Rev. Nephrol.11, 200–202; 2015), in which relevant concerns pertaining
Source: Nature Reviews Nephrology - July 7, 2015 Category: Urology & Nephrology Authors: Arman QamarDeepak L. Bhatt Tags: Reply Source Type: research

Challenging the use of warfarin in patients on dialysis with atrial fibrillation
Nature Reviews Nephrology 11, 450 (2015). doi:10.1038/nrneph.2015.87 Authors: Georg Schlieper & Jürgen Floege We read with great interest the article from Qamar and Bhatt (Anticoagulation therapy: Balancing the risks of stroke and bleeding in CKD. Nat. Rev. Nephrol.11, 200–202; 2015) that discussed the observational study by Bonde et al. on anticoagulation
Source: Nature Reviews Nephrology - July 7, 2015 Category: Urology & Nephrology Authors: Georg SchlieperJürgen Floege Tags: Correspondence Source Type: research

How I Do It: GreenLight XPS 180W photoselective vaporization of the prostate.
The objectives of this article are to breakdown some of the basic steps for the novice user of GL-PVP, as well as impart some 'pearls' for the more experienced user. Nothing can replace hands-on experience for any surgery. The GL-PVP is unique in that there are guides such as this and previous articles, an excellent simulation device (GreenLight SIM), and mentoring programs in place. The success of many surgeries has been the standardization of the procedure. Performing GL-PVP should not be haphazard. A surgical plan based on prostate anatomy and size, cystoscopic appearance, and application of routinized techniques should...
Source: Canadian Journal of Urology - June 13, 2015 Category: Urology & Nephrology Tags: Can J Urol Source Type: research

IMAGES IN CLINICAL MEDICINE Lindsay ’s Nails in Chronic Kidney Disease
This image says it all.  An interesting nail bed finding in CKD. : Intestinal radiopacities in chronic renal failure Case Records of the Massachusetts General Hospital. Case 35-2015: A 72-Year-Old Woman with Proteinuria and a Kidney Mass. Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Source Type: research

IMAGES IN CLINICAL MEDICINE Lindsay’s Nails in Chronic Kidney Disease
This image says it all.  An interesting nail bed finding in CKD. : Intestinal radiopacities in chronic renal failure Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation Use of phosphate-binding agents is associated with a lower risk of mortality
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology 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

Evaluating time in therapeutic range for hemodialysis patients taking warfarin.
In conclusion, this HD unit is not meeting the TTR goal established in the literature and patients are often subtherapeutic. Further studies to investigate ways to improve TTR are warranted. Ultimately, a prospective study evaluating the safety and efficacy of warfarin in HD patients is needed. PMID: 25500296 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - December 15, 2014 Category: Urology & Nephrology Authors: Quinn LM, Richardson R, Cameron KJ, Battistella M Tags: Clin Nephrol 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

Perioperative Aspirin and Clonidine and Risk of Acute Kidney Injury
In this sub-study of the POISE-2 study, neither ASA or clonidine reduced the risk of acute kidney injury after non-cardiac surgery. Of note, aspirin increased the risk of major bleeding (which was associated with a greater risk of acute kidney injury).  As well, clonidine increased the risk of clinically important hypotension (which was associated with a greater risk of acute kidney injury). : Stroke and Bleeding in Atrial Fibrillation with Chronic Kidney Disease Risk of acute kidney injury associated with the use of fluoroquinolones Chronic Dialysis and Death Among Survivors of Acute Kidney Injury Requiring Dialysis
Source: Nephrology Now - November 16, 2014 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Acute Kidney Injury Source Type: research

Acute Kidney Injury and Prognosis After Cardiopulmonary Bypass: A Meta-analysis of Cohort Studies
Conclusions CPB-associated AKI is associated with a more than 2-fold increase in early mortality regardless of AKI definition.
Source: American Journal of Kidney Diseases - November 16, 2014 Category: Urology & Nephrology 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

Use and safety of heparin-free maintenance hemodialysis in the USA
Conclusions Patient markers of increased risk of bleeding and facility region associated with heparin-free HD use. Despite the potential benefits of avoiding heparin use, heparin-free HD was not significantly associated with decreased hazards of death, bleeding or thrombosis, suggesting that it may be no safer than HD with heparin.
Source: Nephrology Dialysis Transplantation - June 18, 2013 Category: Urology & Nephrology Authors: Shen, J. I., Mitani, A. A., Chang, T. I., Winkelmayer, W. C. Tags: Intra- and Extracorporeal Treatment of Kidney Failure Source Type: research