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Prevention and treatment of stroke in patients with chronic kidney disease: an overview of evidence and current guidelines
Chronic Kidney Disease (CKD) is strongly associated with an increased risk of stroke, small vessel disease, and vascular dementia. Common vascular factors for stroke, such as hypertension, diabetes, and atrial fibrillation, are more prevalent in CKD patients, accounting for this association. However, factors unique to these patients, such as uraemia, oxidative stress, mineral and bone abnormalities, as well as dialysis-related factors are also believed to contribute to risk. Despite improvements in stroke treatment and survival in the general population, the rate of improvement in patients with CKD, especially those who ar...
Source: Kidney International - October 17, 2019 Category: Urology & Nephrology Authors: Dearbhla M. Kelly, Peter M. Rothwell Tags: Review Source Type: research

235 Association of stroke with psoriasis in end-stage renal disease patients
Previous research in the general population suggests that the inflammatory skin disease psoriasis is associated with an increased risk of vascular events, such as stroke. Thus, psoriasis may also represent a significant risk factor for stroke in dialysis patients. We queried the United States Renal Data System for incident dialysis patients between 2004 and 2015. Psoriasis was defined as having at least two ICD-9 or ICD-10 diagnosis codes. ICD codes were also used to query the outcome of interest, stroke, as well as other clinical risk factors.
Source: Journal of Investigative Dermatology - April 19, 2021 Category: Dermatology Authors: N. Siddiquee, J. Waller, S. Baer, M. Kheda, A. Mohammed, S. Padala, B. Siddiqui, L. Young, S. Tran, W. Bollag Tags: Patient Population Research Source Type: research

Anticoagulation use and the risk of stroke and major bleeding in patients on hemodialysis: From the VIVALDI, a population-based prospective cohort study
CONCLUSIONS: Although the non-randomized nature of the study is prone to bias, anticoagulation with VKA was not associated with decreased thromboembolic risk, but associated with increased risk of major bleeding and may be net-harmful to patients with AF on HD.PMID:34418291 | DOI:10.1111/jth.15508
Source: Thrombosis and Haemostasis - August 21, 2021 Category: Hematology Authors: Oliver K önigsbrügge Hannah Meisel Aljoscha Beyer Sabine Schmaldienst Renate Klauser-Braun Matthias Lorenz Martin Auinger Josef Kletzmayr Manfred Hecking Wolfgang C Winkelmayer Irene Lang Ingrid Pabinger Marcus S äemann Cihan Ay Source Type: research

Maybe Pradaxa (dabigatran) does need blood monitoring after all
2.5 out of 5 stars The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients. Reilly PA et al. J Am Coll Cardiol 2014 Feb 4;63:321-8. Abstract A must-read article in yesterday’s New York Times described the internal battle at Boehringer Ingelheim, the maker of Pradaxa (dabiagtran etexilate), concerning the publication of this study. A major marketing point posited in favor of dabigatran over warfarin for the prevention of stroke in patients with atrial fibrillation was that it did not require monitoring with reg...
Source: The Poison Review - February 7, 2014 Category: Toxicology Authors: Leon Tags: Medical bleeding blood testing boehringer ingelheim dabigatran pradaxa stroke Source Type: news

Incidence and prediction of ischemic stroke among atrial fibrillation patients with end-stage renal disease requiring dialysis
Renal dysfunction is a significant risk factor for ischemic stroke in atrial fibrillation (AF). However, the incidence of ischemic stroke and how to predict its occurrence among AF patients with end-stage renal disease (ESRD) are unclear.
Source: Heart Rhythm - June 18, 2014 Category: Cardiology Authors: Tze-Fan Chao, Chia-Jen Liu, Kang-Ling Wang, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Fa-Po Chung, Jo-Nan Liao, Tzeng-Ji Chen, Gregory Y.H. Lip, Shih-Ann Chen Source Type: research

Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Conclusions In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range.
Source: Nephrology Dialysis Transplantation - February 23, 2015 Category: Urology & Nephrology Authors: Genovesi, S., Rossi, E., Gallieni, M., Stella, A., Badiali, F., Conte, F., Pasquali, S., Bertoli, S., Ondei, P., Bonforte, G., Pozzi, C., Rebora, P., Valsecchi, M. G., Santoro, A. Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research

Risk of major cardiovascular events in patients with hemodialysis or peritoneal dialysis with special reference to stroke
Kim et al. determined the incidence rates of major adverse cardiac and cerebrovascular events (MACCE) and compared several types of events between hemodialysis (HD) patients and peritoneal dialysis (PD) patients [1]. The authors handled 22,892 HD patients and 7,387 PD patients in Korea by intention-to-treat method, and median follow-up period was 21.5 months. The risk of several cardiac events in PD patients was significantly higher than that in HD patients. In contrast, the incidence rate of non-fatal hemorrhagic stroke in HD patients showed significantly higher than that in PD patients, and there was no significant diffe...
Source: International Journal of Cardiology - September 21, 2015 Category: Cardiology Authors: Tomoyuki Kawada Source Type: research

Obesity Paradox in Patients Hospitalized for Acute Ischemic Stroke: An Analysis of Nationwide Inpatient Sample Data (S47.008)
Conclusions: Among patients hospitalized for AIS, obese patients had lower risk adjusted in-hospital mortality. Similar trend persisted among IV-tpa and non IV-tpa group. The association of obesity and better prognosis, also known as the "obesity paradox" holds true for AIS. This is the first study of its kind on the largest all payer database. However, further studies are required to establish causal relationship for this phenomenon.Disclosure: Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Savani has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Jani has nothing to disclose. ...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Lunagariya, A., Patel, A., Savani, C., Patel, U., Jani, V., Hussain, S., Mehta, S. Tags: IV-tPA and Endovascular Therapy Source Type: research

Cardiovascular and Stroke Risk in Japanese Hemodialysis Patients With Atrial Fibrillation
Abstract Atrial fibrillation is one of the most common arrhythmias in hemodialysis patients. We evaluated its clinical outcomes among hemodialysis patients with atrial fibrillation in Japan. Using data derived from the Japanese Dialysis Outcomes and Practice Patterns Study, we analyzed backgrounds and outcomes among hemodialysis patients with and without atrial fibrillation in Japan. Among 7002 hemodialysis patients, the prevalence of atrial fibrillation was 5.7% and the incidence was 0.2 per 100 patient‐years. Atrial fibrillation was independently associated with all‐cause mortality (hazard ratio, 1.32; 95% confidence...
Source: Therapeutic Apheresis and Dialysis - September 30, 2016 Category: Hematology Authors: Jumpei Hasegawa, Brian Bieber, Maria Larkina, Bruce M. Robinson, Sachiko Wakai, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Takashi Akiba Tags: Original Article Source Type: research

Effects of stroke on changes in heart rate variability during hemodialysis
Stroke and low heart rate variability (HRV) are both associated with an unfavorable prognosis in hemodialysis patients. The relationship between stroke and changes in HRV during hemodialysis remains unclear.
Source: BMC Nephrology - March 16, 2017 Category: Urology & Nephrology Authors: Jiun-Chi Huang, Chien-Fu Chen, Chia-Chu Chang, Szu-Chia Chen, Ming-Chia Hsieh, Yao-Peng Hsieh and Hung-Chun Chen Source Type: research

Low-dose Apixaban May Be Safe Anti-stroke Option for Dialysis Patients Low-dose Apixaban May Be Safe Anti-stroke Option for Dialysis Patients
Low-dose apixaban achieves blood levels that appear to be safe and might be a “ reasonable alternative ” to warfarin for preventing stroke in patients with atrial fibrillation who are on hemodialysis, new research suggests.Reuters Health Information
Source: Medscape Critical Care Headlines - March 24, 2017 Category: Intensive Care Tags: Neurology & Neurosurgery News Source Type: news

Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease
Background: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain.Summary: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA. Limited data fr...
Source: Cardiorenal Medicine - April 26, 2017 Category: Urology & Nephrology Source Type: research

ESRD After Heart Failure, Myocardial Infarction, or Stroke in Type  2 Diabetic Patients With CKD
Conclusions Most ESRD cases occurred in individuals without intercurrent CV events who had lower eGFRs than individuals with intercurrent CV events, but similar post-ESRD mortality. Nevertheless, intercurrent CV events, particularly heart failure, are strongly associated with risk for ESRD. These findings underscore the need for kidney-specific therapies in addition to treatment of CV risk factors to lower ESRD incidence in diabetes.
Source: American Journal of Kidney Diseases - June 7, 2017 Category: Urology & Nephrology Source Type: research