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Procedure- Related and Perioperative Strokes in Patients on Hemodialysis: A 10-Year Retrospective Study (P6.046)
Conclusion: Peri-procedural and peri-operative strokes are common in patients on Hemodialysis and highest risk is in the period soon after the procedure. Further studies should be directed towards better surgical risk stratification and stroke prevention pre-operatively in these patients.Disclosure: Dr. Sunbulli has nothing to disclose. Dr. Sachar has nothing to disclose. Dr. Rajamani has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Sunbulli, M., Sachar, P., Rajamani, K. Tags: In-Hospital Stroke and Stroke Complications 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

Influence of chronic kidney disease and haemodialysis on stroke outcome
CONCLUSION: Despite significant functional and neurological improvements following rehabilitation, stroke patients with underlying CKD had higher average duration of hospital stay, more recurrent hospitalisations and poorer survival outcomes than those without underlying CKD. This could be attributed to the complications associated with CKD rather than stroke. Multidisciplinary community rehabilitation may be an alternative to reduce recurrent hospitalisations and morbidity in this group of patients. PMID: 32241068 [PubMed - as supplied by publisher]
Source: Singapore Medical Journal - April 2, 2020 Category: General Medicine Authors: Pande SD, Morris J Tags: Singapore Med J Source Type: research

Ischaemic stroke in patients with atrial fibrillation with chronic kidney disease undergoing peritoneal dialysis
Conclusion In CKD patients on PD with AF, who had similar ischaemic stroke risk as non-CKD counterparts, warfarin therapy is associated with reduction in risk of ischaemic stroke without a higher risk of ICH.
Source: Europace - May 24, 2016 Category: Cardiology Authors: Chan, P.-H., Huang, D., Yip, P.-S., Hai, J., Tse, H.-F., Chan, T.-M., Lip, G. Y. H., Lo, W.-K., Siu, C.-W. Tags: Atrial fibrillation Source Type: research

Association of intermittent versus continuous hemodialysis modalities with mortality in the setting of acute stroke among patients with end-stage renal disease
Patients with end-stage renal disease (ESRD) are 8–10 times more likely to suffer from a stroke compared with the general public. Despite this risk, there are minimal data elucidating which hemodialysis modality is best for patients with ESRD following a stroke, and guidelines for their management are lacking. We retrospectively queried the US Renal Data System administrative database for all-cause mortality in ESRD stroke patients who received either intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT). Acute ischemic stroke and hemorrhagic stroke were identified using the International Cla...
Source: Journal of Investigative Medicine - October 3, 2022 Category: Research Authors: Morgan, M. C., Waller, J. L., Bollag, W. B., Baer, S. L., Tran, S., Kheda, M. F., Young, L., Padala, S., Siddiqui, B., Mohammed, A. Tags: Original research 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

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

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

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

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

Stroke feature and management in dialysis patients.
Abstract Strokes remain the major complication among dialysis population as the number of diabetes and elderly is increasing. In chronic hemodialysis patients, prevalence and incidence of stroke is higher than that of the general population. According to the annual registry data of the Japanese Society for Dialysis Therapy, prevalence of stroke death has been declining, yet the incidence of nonfatal incidence of stroke is not known. Underlying mechanisms of stroke are multiple. Among them, control of hypertension is important for the primary prevention; however, the ideal target level of blood pressure is not dete...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Iseki K Tags: Contrib Nephrol Source Type: research

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