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Condition: Hemorrhagic Stroke
Procedure: Dialysis

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Total 220 results found since Jan 2013.

Evidence for the Prevention and Treatment of Stroke in Dialysis Patients
Abstract The risks of both ischemic and hemorrhagic stroke are particularly high in dialysis patients of any age and outcomes are poor. It is therefore important to identify strategies that safely minimize stroke risk in this population. Observational studies have been unable to clarify the relative importance of traditional stroke risk factors such as blood pressure and cholesterol in those on dialysis, and are affected by biases that usually make them an inappropriate source of data on which to base therapeutic decisions. Well‐conducted randomized trials are not susceptible to such biases and can reliably investigate t...
Source: Seminars In Dialysis - May 1, 2014 Category: Hematology Authors: William Herrington, Richard Haynes, Natalie Staplin, Jonathan Emberson, Colin Baigent, Martin Landray Tags: Review Source Type: research

Acute Renal Failure Is Associated With Higher Death and Disability in Patients With Acute Ischemic Stroke: Analysis of Nationwide Inpatient Sample Brief Reports
Conclusions— ARF in patients with AIS is associated with significantly higher rates of moderate to severe disability at discharge and in-hospital mortality.
Source: Stroke - April 28, 2014 Category: Neurology Authors: Saeed, F., Adil, M. M., Khursheed, F., Daimee, U. A., Branch, L. A., Vidal, G. A., Qureshi, A. I. Tags: Acute Cerebral Infarction Brief Reports Source Type: research

Strategy to a 5 Minute Door to Needle Time (S5.005)
CONCLUSIONS:Our experience suggests that the "Target: Stroke" strategies (EMS initiation of stroke codes, rapid triage, rt-PA before labs), SMART criteria, and three question tool to predict abnormal coagulation can significantly reduce the time to thrombolysis. However, a multi-disciplinary team, educated and dedicated to providing rapid ischemic stroke treatment, and the development of a culture in which faster treatment is a goal, is a factor that’s impact cannot be measured.Study Supported by:Disclosure: Dr. Parker has nothing to disclose. Dr. Swanson-Devlin has nothing to disclose. Dr. Jahnel has received person...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Parker, S., Swanson-Devlin, T., Jahnel, J., McNeil, C., Talkad, A., Beck, J., Nair, D., Wang, D. Tags: Cerebrovascular Disease and Interventional Neurology: Pre-hospital, Telemedicine, and Related Topics Source Type: research

Ischemic and Hemorrhagic Stroke: High Incidence in Hemodialysis and Peritoneal Dialysis Patients
Related Article, p. 604
Source: American Journal of Kidney Diseases - March 27, 2014 Category: Urology & Nephrology Authors: David A. Drew, Mark J. Sarnak Tags: Editorials Source Type: research

Risk of intracranial hemorrhage associated with autosomal dominant polycystic kidney disease in patients with end stage renal disease
Conclusions: ADPKD is a significant risk factor for ICH among patients on maintenance dialysis. Our Medicare primary cohort was older than in previous studies of intracranial aneurysm rupture among ADPKD patients. There are also limitations inherent to using the USRDS database.
Source: BioMed Central - February 26, 2014 Category: Journals (General) Authors: David J YooLawrence AgodoaChristina M YuanKevin C AbbottRobert Nee Source Type: research

Race, Ethnicity, and State-by-State Geographic Variation in Hemorrhagic Stroke in Dialysis Patients.
CONCLUSION: Race and ethnicity, or other factors that covary with these, appear to explain a substantial portion of state-by-state geographic variation in hemorrhagic stroke. This finding suggests that the factors underlying the high rate of hemorrhagic strokes in dialysis patients are likely to be system-wide and that further investigations into regional variations in clinical practices are unlikely to identify large opportunities for preventive interventions for this disorder. PMID: 24458073 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - January 23, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Mahnken JD, Ellerbeck EF, Rigler SK, Zhou X, Shireman TI Tags: Clin J Am Soc Nephrol Source Type: research

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran
Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not ‘routine’. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated p...
Source: Emergency Medicine Journal - January 15, 2014 Category: Emergency Medicine Authors: Alikhan, R., Rayment, R., Keeling, D., Baglin, T., Benson, G., Green, L., Marshall, S., Patel, R., Pavord, S., Rose, P., Tait, C. Tags: Poisoning/Injestion, Open access, Drugs: cardiovascular system, Stroke, Poisoning Review Source Type: research

Clinical Experience of Life-Threatening Dabigatran-Related Bleeding at a Large, Tertiary Care, Academic Medical Center: a Case Series.
CONCLUSION: Reversal strategies for dabigatran-related bleeding events at our institution are highly variable. Intracranial hemorrhage in patients on dabigatran was associated with 43 % mortality. Patients with severe dabigatran-related bleeding may benefit from a standardized approach to treatment. PMID: 24385325 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - January 3, 2014 Category: Toxicology Authors: Ross B, Miller MA, Ditch K, Tran M Tags: J Med Toxicol Source Type: research

Patient with acute renal injury presenting dabigatran overdose: Hemodialysis for surgery.
We report a case of an 80-year-old man presenting hemorrhage with dabigatran overdose caused by obstructive acute renal failure. Before nephrostomy, several hemodialysis sessions were necessary to remove dabigatran probably because of its large volume of distribution. PMID: 24378048 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - December 27, 2013 Category: Anesthesiology Authors: Bachellerie B, Ruiz S, Conil JM, Crognier L, Seguin T, Georges B, Fourcade O Tags: Ann Fr Anesth Reanim Source Type: research

Nontraumatic Subarachnoid Hemorrhage in Maintenance Dialysis Hospitalizations: Trends and Outcomes Clinical Sciences
Conclusions— SAH hospitalizations are more common and associated with higher mortality in patients on maintenance dialysis than in the general population. Although being on maintenance dialysis is an independent predictor for mortality in patients with SAH, other predictors of mortality evaluated in this study are not necessarily different between the 2 groups.
Source: Stroke - December 23, 2013 Category: Neurology Authors: Sakhuja, A., Schold, J. D., Kumar, G., Katzan, I., Navaneethan, S. D. Tags: Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage Clinical Sciences Source Type: research

Risk of Stroke in Long-term Dialysis Patients Compared With the General Population
Conclusions: Patients undergoing dialysis are at elevated risk of stroke. Patients undergoing PD appear to be less likely to develop hemorrhagic stroke than those undergoing HD. Comprehensive control of hypertension and diabetes is necessary when delivering dialysis treatment.
Source: American Journal of Kidney Diseases - December 2, 2013 Category: Urology & Nephrology Authors: Hsi-Hao Wang, Shih-Yuan Hung, Junne-Ming Sung, Kuan-Yu Hung, Jung-Der Wang Tags: Dialysis Source Type: research

More Studies Required to Understand Mortality Rates of Dialysis-Dependent Patients after Acute Thrombolysis for Stroke
I read with interest the article by Tariq et al in the Journal that details outcomes with thrombolytic therapy for acute ischemic stroke in over 1000 dialysis patients. They are to be commended for examining this important aspect of acute stroke care in dialysis cohorts. However, in their discussion, the authors state that a previous US study by Sozio et al reported a 30-day mortality rate of 35% after thrombolysis. This is inaccurate and can potentially cause confusion. In fact, careful review of the article reveals that the authors of that study do not report any thrombolysis-related outcomes and that this mortality ra...
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2013 Category: Neurology Authors: Albert Power Tags: Letters to the Editor Source Type: research

Response to the Letter by Tariq
We stated in our discussion section that “A previous study16 reported 35% mortality within 30 days of IV rt-PA treatment in dialysis dependent renal failure patients.” The mention of IV rt-PA in these patients is a mistake on our part. The 35% mortality within 30 days reported by Sozio et al was reported for all stroke subtypes including hemorrhagic strokes. The following study does not mention if IV rt-PA was administered or not in these patients.
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2013 Category: Neurology Authors: Nauman Tariq, Adnan I. Qureshi Tags: Letters to the Editor 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

Cerebrorenal interaction and stroke.
Abstract Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microb...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Toyoda K Tags: Contrib Nephrol Source Type: research