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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

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

Association of blood pressure with all‐cause mortality and stroke in Japanese hemodialysis patients: The Japan dialysis outcomes and practice pattern study
Abstract The association of low blood pressure (BP) with high mortality is a characteristic for hemodialysis patients. This analysis clarifies the association of BP with mortality and stroke in Japanese hemodialysis (HD) patients and examines the association separately for patients with and without antihypertensive medication (BP meds). We analyzed 9134 patients from Japan in phases 1–4 (1999–2011) of the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective cohort study of in‐center HD patients. The association of patient systolic (SBP) and diastolic (DBP) blood pressure with all‐cause and cause‐s...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Masaaki Inaba, Angelo Karaboyas, Takashi Akiba, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Christian Combe, Bruce M. Robinson Tags: Original Article Source Type: research

High Stroke Volume Variation Is an Independent Predictor for Decreased Blood Pressure During Hemodialysis
Abstract It currently remains unclear whether stroke volume variation (SVV) before hemodialysis (HD) is an independent predictor of decreased blood pressure (BP) during HD. Fifty‐two patients were divided into two groups (Decreased BP during HD group: N = 10, Non‐decreased BP group: N = 42). Fractional shortening was lower, and mean arterial pressure (MAP) and SVV were higher in the Decreased BP during HD group. A multiple logistic regression analysis identified low fractional shortening, high MAP, and high SVV as independent predictors of decreased BP during HD. The areas under the ROC curves were as follows: 0.84...
Source: Therapeutic Apheresis and Dialysis - March 9, 2017 Category: Hematology Authors: Fumiki Yoshihara, Masatsugu Kishida, Koji Ogawa, Takayuki Nishigaki, Hironori Nakasaki, Azusa Ishizuka, Ryo Koezuka, Miki Matsuo, Teruyuki Hayashi, Satoko Nakamura Tags: Original Article Source Type: research

Prevalence and correlates of functional dependence among maintenance dialysis patients
Abstract Functional dependence is an important determinant of longevity and quality of life. The purpose of the current study was to determine the prevalence and correlates of functional dependence among patients with end‐stage renal disease (ESRD) receiving maintenance dialysis. We enrolled 148 participants with ESRD from five clinics. Functional status, as measured by basic and instrumental activities of daily living (ADL, IADL), was ascertained by validated questionnaires. Functional dependence was defined as needing assistance in at least one of seven IADLs or at least one of four ADLs. Demographic characteristics, c...
Source: Hemodialysis International - March 2, 2015 Category: Hematology Authors: Niall T. Kavanagh, Brigitte Schiller, Anjali B. Saxena, I‐Chun Thomas, Manjula Kurella Tamura Tags: Original Article Source Type: research

Blood Pressure Recordings During Hemodialysis Access Interventions: Implications for Acute Management
Abstract A retrospective study evaluating the pattern of blood pressure and its related complications before, during, and after percutaneous hemodialysis interventions was performed in patients presenting with asymptomatic hypertension. Hemodialysis patients undergoing percutaneous interventions including tunneled hemodialysis catheter insertion, percutaneous balloon angioplasty and thrombectomy procedure, and stage II hypertension (systolic blood pressure ≥160 mmHg) were included in this analysis. Blood pressure medications were not used while midazolam and fentanyl were routinely administered. Patients were followed f...
Source: Seminars In Dialysis - March 28, 2013 Category: Hematology Authors: Arif Asif, Hector Castro, Ahmed Ameen Waheed, Vishesh Kumar, Syed S Haqqie, Gary Siskin, Roy O Mathew, Darius Mason, Tushar Vachharajani, Ali Nayer, Donna Merrill, Muhammad UT Akmal, Loay Salman Tags: Investigation 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 clinical routin...
Source: Seminars In Dialysis - January 9, 2014 Category: Hematology Authors: Thilo Krüger, Jürgen Floege Tags: Review Source Type: research

Piperacillin/tazobactam‐induced neurotoxicity in a hemodialysis patient: A case report
This report presents a case of a hypertensive and diabetic 67‐year‐old woman in regular hemodialysis, which previously had a stroke. She was hospitalized presenting pneumonia, which was initially treated with cefepime. Two days after treatment, she presented dysarthria, left hemiparesis, ataxia, and IX and X cranial nerves paresis. Computed tomography showed no acute lesions and cefepime neurotoxicity was hypothesized, and the antibiotic was replaced by piperacillin/tazobactam. The neurologic signs disappeared; however, 4 days after with piperacillin/tazobactam treatment, the neurological manifestations returned. A new...
Source: Hemodialysis International - July 1, 2014 Category: Hematology Authors: Precil Diego M. M. Neves, Fernanda M. Freitas, Christiane A. Kojima, Beatriz L. Carmello, Rodrigo Bazan, Pasqual Barretti, Luis C. Martin Tags: Case Report Source Type: research

Intracerebral hemorrhage was the highest cause of mortality among stroke subtypes in Japanese dialysis patients
Source: Hemodialysis International - July 1, 2014 Category: Hematology Authors: Minako Wakasugi, Junichiro J. Kazama, Ichiei Narita Tags: Letter to the Editor Source Type: research

Changes in Volumetric Hemodynamic Parameters Induced by Fluid Removal on Hemodialysis in Critically Ill Patients
Abstract Management of volume status is difficult in critically ill patients with renal failure. Volumetric hemodynamic indices are increasingly being used to guide fluid therapy in the intensive care unit (ICU), but are not established to monitor hemodialysis‐induced fluid removal in critically ill patients. Using volumetric hemodynamic monitoring, changes in extravascular lung water index (EVLWI) and intrathoracic blood volume index (ITBVI) were measured immediately before and after hemodialysis sessions in 35 ICU patients. Additional hemodynamic and oxygenation related parameters were recorded at the same time, and on...
Source: Therapeutic Apheresis and Dialysis - September 4, 2014 Category: Hematology Authors: Friederike Compton, Marie Vogel, Walter Zidek, Markus Giet, Timm Westhoff Tags: Original Article Source Type: research

Pharmacokinetics, safety, and tolerability of edoxaban in end-stage renal disease subjects undergoing haemodialysis.
In conclusion, based on these single-dose PK data, a supplementary dose of edoxaban may not be required following a haemodialysis session. Importantly, haemodialysis is not an effective mechanism for removal of edoxaban from the blood. PMID: 25566930 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 8, 2015 Category: Hematology Authors: Parasrampuria DA, Marbury T, Matsushima N, Chen S, Wickremasingha PK, He L, Dishy V, Brown KS Tags: Thromb Haemost Source Type: research

Dabigatran treatment simulation in patients undergoing maintenance haemodialysis.
This study simulated the dose-exposure relationship of dabigatran in patients undergoing haemodialysis. Dabigatran exposure was modelled at once- and twice-daily doses of 75 mg, 110 mg and 150 mg and at variations in non-renal clearance and dialysis settings. Resultant dose exposure (area under the curve [AUC]) was compared with values simulated from typical patients in the RE-LY® trial (based on a previously characterised pharmacometric model). In this simulation, all twice-daily dosages resulted in exposures above those simulated from typical RE-LY patients (1.5- to 3.3-fold increase in AUC) and thus may not be optimal ...
Source: Thrombosis and Haemostasis - October 15, 2015 Category: Hematology Authors: Liesenfeld KH, Clemens A, Kreuzer J, Brueckmann M, Schulze F Tags: Thromb Haemost Source Type: research

Antithrombotic therapy in end ‐stage renal disease
Abstract The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidn...
Source: Hemodialysis International - April 1, 2017 Category: Hematology Authors: Svetha Chunduri, Jon E. Folstad, Tushar J. Vachharajani Tags: Review Article Source Type: research

A brief review of intradialytic hypotension with a focus on survival
Abstract Intradialytic hypotension (IDH), a common complication of ultrafiltration during hemodialysis therapy, is associated with high mortality and morbidity. IDH, defined as a nadir systolic blood pressure of less than 90 mm Hg on more than 30% of treatments, is a relevant definition and is correlated with mortality. Risk factors for IDH include patient demographics, anti‐hypertensive medication use, larger interdialytic weight gain, and dialysis prescription features as dialysate sodium, high ultrafiltration rate, and dialysate temperature. A high frequency of IDH events carries a substantial death risk. An ultrafilt...
Source: Seminars In Dialysis - May 1, 2017 Category: Hematology Authors: Jason A. Chou, Kamyar Kalantar ‐Zadeh, Anna T. Mathew Tags: INTRADIALYTIC HYPOTENSION: PERSPECTIVES IN CONTEMPORARY PRACTICE Source Type: research

Pitavastatin Compared with Differential Intervention Trial by Standard Therapy on Cardiovascular Events in Patients with Dyslipidemia on Chronic Hemodialysis (DIALYSIS): A Randomized Controlled Trial
Conclusion: Our study has demonstrated that aggressive intervention with pitavastatin is more effective than the standard (dietary) therapy for improving the clinical outcomes in patients with dyslipidemia on chronic hemodialysis.Blood Purif
Source: Blood Purification - January 30, 2023 Category: Hematology Source Type: research

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