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Therapy: Dialysis
Nutrition: Vitamin K

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Total 28 results found since Jan 2013.

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

Primary Prevention of Stroke in Chronic Kidney Disease Patients: A Scientific Update
Background: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking.Summary: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population. The use of oral anticoagulation in AF appears safe...
Source: Cerebrovascular Diseases - January 9, 2018 Category: Neurology Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

New XARELTO ® (rivaroxaban) Peripheral Artery Disease (PAD) Data from EXPLORER Clinical Research Program to be Unveiled at American Heart Association (AHA) Scientific Sessions 2020
RARITAN, N.J., November 9, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that 10 data presentations will be shared at the virtual American Heart Association (AHA) Scientific Sessions 2020 from November 13-17. Most notably, four new sub-analyses of XARELTO® (rivaroxaban) from the landmark VOYAGER PAD trial, part of the EXPLORER global cardiovascular research program, will be presented, including two live, featured science oral presentations. “We're pleased VOYAGER PAD was selected to be front and center once again at a major medical congress, as there's an urgent need for data in ...
Source: Johnson and Johnson - November 9, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

Direct oral anticoagulants in chronic kidney disease: an update
Purpose of review Direct oral anticoagulants (DOACs) are variably eliminated by the kidneys rendering their use potentially problematic in patients with chronic kidney disease (CKD) or necessitating appropriate dose adjustment. Recent findings Both observational and limited randomized trial data for DOACs compared with no treatment or with warfarin for patients with atrial fibrillation on maintenance dialysis were recently published. In a randomized trial in patients on hemodialysis, there was no significant difference in vascular calcification between patients who received rivaroxaban with or without vitamin K2 or vi...
Source: Current Opinion in Nephrology and Hypertension - August 1, 2020 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Cardiovascular and renal outcomes in patients with atrial fibrillation and stage 4 –5 chronic kidney disease receiving direct oral anticoagulants: a multicenter retrospective cohort study
AbstractThe role of direct oral anticoagulants (DOAC) in patients with atrial fibrillation (AF) and stage 4 –5 chronic kidney disease (CKD) is controversial. Electronic medical records from 2012 to 2021 were retrieved for patients with AF and stage 4–5 CKD receiving oral anticoagulants. Patients were separated into those receiving DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) or vitamin K ant agonists (VKA). Primary outcomes included ischemic stroke (IS), systemic thrombosis (SE), major bleeding, gastrointestinal bleeding, hemorrhagic stroke, acute myocardial infarction, cardiovascular death, and all-cause dea...
Source: Journal of Thrombosis and Thrombolysis - August 21, 2023 Category: Hematology 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

The use of non-vitamin K oral anticoagulants in dialysis patients-A systematic review
This study investigated the available evidence for the use of NOACs in dialysis patients. Online databases were systematically searched for eligible studies including pharmacokinetic (PK) studies, cohort studies, and randomized control trials (RCTs) comparing NOAC with vitamin K antagonist (VKA) or no anticoagulant treatment. Newcastle Ottawa Scale and Cochrane Risk of bias tool were used for quality assessment. Twenty studies were identified (nine PK studies, two RCTs, and nine cohort studies). Most of the studies investigated apixaban or rivaroxaban. In dialysis patients, less accumulation was reported with apixaban and ...
Source: Seminars in Dialysis - May 27, 2022 Category: Urology & Nephrology Authors: Agitha Chandrasegaram Christian Daugaard Peters Source Type: research

The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcification: ongoing randomized controlled trials
Conclusion Vitamin K deficiency may be a modifiable cardiovascular risk factor in the haemodialysis population. Conversely, vitamin K antagonists may aggravate VC burden in haemodialysis patients. Several ongoing trials may provide an answer to these questions in the near future.
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Caluwe, R., Pyfferoen, L., De Boeck, K., De Vriese, A. S. Tags: CKD-MBD Source Type: research

Variability In NOAC Dose Adjustment In Atrial Fibrillation Patients With Renal Dysfunction: The Influence Of Renal Function Estimation Formulae
Conclusion MDRD and CKD-EPI eGFR fails to correctly identify a significant proportion of patients that require NOAC dose adjustment, limiting their clinical utility. Cockcroft-Gault eCrCl should be calculated for all patients in whom a NOAC is being prescribed. Teaser While glomerular filtration rate is the most common estimates of renal function employed in practice the landmark stroke prevention trials use of the Cockcroft-Gault creatinine clearance equation to determine drug eligibility and dose adjustment. In a large cohort of patients with non-dialysis dependent chronic kidney disease and atrial fibrillation the use o...
Source: Canadian Journal of Cardiology - April 26, 2018 Category: Cardiology Source Type: research

Anticoagulation in Patients with Advanced Chronic Kidney Disease: Walking the Fine Line between Benefit and Harm
Publication date: Available online 11 July 2019Source: Canadian Journal of CardiologyAuthor(s): Januvi Jegatheswaran, Gregory L. Hundemer, David Massicotte-Azarniouch, Manish M. SoodAbstractChronic kidney disease affects over 3 million Canadians and is highly associated with cardiovascular diseases that require anticoagulation, such as atrial fibrillation and venous thromboembolism. Patients with chronic kidney disease are at a problematic crossroads; they are at high risk of both thrombotic conditions requiring anticoagulation and bleeding complications due to anticoagulation. The limited high-quality clinical evidence to...
Source: Canadian Journal of Cardiology - July 12, 2019 Category: Cardiology Source Type: research

Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis.
Conclusion: In early-stage CKD, NOACs had a benefit-risk profile superior to that of VKAs. For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs or NOACs. Primary Funding Source: None. (PROSPERO: CRD42017079709). PMID: 31307056 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - July 15, 2019 Category: Internal Medicine Authors: Ha JT, Neuen BL, Cheng LP, Jun M, Toyama T, Gallagher MP, Jardine MJ, Sood MM, Garg AX, Palmer SC, Mark PB, Wheeler DC, Jha V, Freedman B, Johnson DW, Perkovic V, Badve SV Tags: Ann Intern Med Source Type: research