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Total 1671 results found since Jan 2013.

New Insights into Nonvitamin K Antagonist Oral Anticoagulants' Reversal of Intracerebral Hemorrhage.
Authors: Yasaka M Abstract The nonvitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban are associated with an equal or lower incidence of stroke and systemic embolism and a much lower incidence of intracranial hemorrhage and hemorrhagic stroke than warfarin is, without the need for routine laboratory monitoring. However, reversal strategies are not currently established in the case of NOAC-related hemorrhagic stroke. In emergency situations, well-defined management for NOAC-related hemorrhagic stroke may improve clinical outcomes. Thus, in this chapter, general measures i...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

A contemporary evaluation of carotid endarterectomy outcomes in patients with chronic kidney disease in the United States.
Conclusions Patients with ESRD undergoing CEA had an increased risk of respiratory and septic complications, but not a higher risk of stroke compared to patients with normal renal function. The greatest risks of postoperative stroke, respiratory, and cardiac complications were found in patients with CKD. A diagnosis of ESRD and CKD were both found to significantly increase hospital mortality, length of stay and cost. Where clinicians typically consider ESRD patients the highest risk for CEA, further consideration should be given to patients with CKD not yet on dialysis as they had the higher risk of cardiac complications a...
Source: Vascular - December 31, 2016 Category: Surgery Authors: Patel AR, Dombrovskiy VY, Vogel TR Tags: Vascular Source Type: research

Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).
CONCLUSIONS: In studies of adults with CKD G5D treated with dialysis, sevelamer may lower death (all causes) compared to calcium-based binders and incur less treatment-related hypercalcaemia, while we found no clinically important benefits of any phosphate binder on cardiovascular death, myocardial infarction, stroke, fracture or coronary artery calcification. The effects of binders on patient-important outcomes compared to placebo are uncertain. In patients with CKD G2 to G5, the effects of sevelamer, lanthanum, and iron-based phosphate binders on cardiovascular, vascular calcification, and bone outcomes compared to place...
Source: Cochrane Database of Systematic Reviews - August 22, 2018 Category: General Medicine Authors: Ruospo M, Palmer SC, Natale P, Craig JC, Vecchio M, Elder GJ, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Atrial fibrillation and associated outcomes in patients with peritoneal dialysis and hemodialysis: a 14-year nationwide population-based study.
CONCLUSION: In patients with ESRD undergoing dialysis, PD had lowered risks of new onset of AF compared to HD. Subsequently, these AF patients in PD group had comparable incidence of ischemic stroke but decreased incidence of hemorrhagic stroke compared to AF patients in HD group. PD could be the most suitable modality in patients at risk for the onset of AF. PMID: 32086785 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - February 20, 2020 Category: Urology & Nephrology Authors: Chang CH, Fan PC, Lin YS, Chen SW, Lin MS, Wu M, Chang PC, Lin FC, Chu PH, Wu VC Tags: J Nephrol Source Type: research

Outcomes After Warfarin Initiation in a Cohort of Hemodialysis Patients With Newly Diagnosed Atrial Fibrillation
Conclusions In hemodialysis patients with incident AF, warfarin use was marginally associated with reduced risk of ischemic stroke, and there was a signal toward reduced mortality in as-treated analyses. These results support clinical equipoise regarding the use of warfarin in hemodialysis patients and underscore the need for randomized trials to fill this evidence gap.
Source: American Journal of Kidney Diseases - July 9, 2015 Category: Urology & Nephrology Source Type: research

Revascularization in Patients With Multivessel Coronary Artery Disease and Chronic Kidney Disease Everolimus-Eluting Stents Versus Coronary Artery Bypass Graft Surgery
ConclusionsIn patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps MI, with no long-term mortality difference. In the subgroup on dialysis, the results favored CABG over PCI.
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology Source Type: research

Editorial Commentary: Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established and, in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1, 2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors as well as the incre...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Source Type: research

Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established, and in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1,2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation, possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors and to the increased...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Tags: Editorial Commentary Source Type: research

Long-term Clinical Outcomes of Elective Carotid Artery Stenting in Patients Undergoing Maintenance Hemodialysis.
Conclusion CAS in maintenance hemodialysis patients may be feasible and effective for the prevention of stroke with proper case selection, appropriate technique and strict perioperative management. The most common causes of death during the follow-up of maintenance hemodialysis patients were diseases other than stroke. PMID: 32062623 [PubMed - in process]
Source: Internal Medicine - February 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

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

Apixaban for Patients with Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial
CONCLUSIONS: There was inadequate power to draw any conclusion regarding rates of major or clinically relevant non-major bleeding comparing apixaban and warfarin in patients with AF and ESKD on hemodialysis. Clinically relevant bleeding events were approximately 10-fold more frequent than stroke or systemic embolism among this population on anticoagulation, highlighting the need for future randomized studies evaluating the risks versus benefits of anticoagulation among patients with AF and ESKD on hemodialysis.PMID:36335914 | DOI:10.1161/CIRCULATIONAHA.121.054990
Source: Circulation - November 6, 2022 Category: Cardiology Authors: Sean D Pokorney Glenn M Chertow Hussein R Al-Khalidi Dianne Gallup Pat Dignaco Kurt Mussina Nisha Bansal Crystal A Gadegbeku David A Garcia Samira Garonzik Renato D Lopes Kenneth W Mahaffey Kelly Matsuda John P Middleton Jennifer A Rymer George H Sands Ra Source Type: research

Low Plasma α-Tocopherol Concentrations and Adverse Clinical Outcomes in Diabetic Hemodialysis Patients.
CONCLUSIONS: Plasma α-tocopherol concentrations were not independently associated with cardiovascular outcomes, infectious deaths, or all-cause mortality in diabetic hemodialysis patients. The lack of association can partly be explained by a confounding influence of malnutrition, which should be considered in the planning of trials to reduce cardiovascular risk in dialysis patients. PMID: 23335039 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - January 18, 2013 Category: Urology & Nephrology Authors: Espe KM, Raila J, Henze A, Blouin K, Schneider A, Schmiedeke D, Krane V, Pilz S, Schweigert FJ, Hocher B, Wanner C, Drechsler C, for the German Diabetes and Dialysis Study Investigators Tags: Clin J Am Soc Nephrol 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

Screening for transient ischemic attacks in hemodialysis patients.
Conclusions: Based on the first study of its kind to date, systematic screening for TIA has a low yield and cannot be relied on alone to identify patients at higher risk of cerebrovascular events. The confounding presence of symptoms attributable to uremia, neuropathy, hypotension and dysglycemia could reduce the sensitivity of established tests, with significant implications for the detection and treatment of TIA in dialysis. PMID: 23807647 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - May 23, 2013 Category: Urology & Nephrology Authors: Power A, Edwards C, Sawyer J, Tandaric D, Dahdaleh D, Taube D, Duncan N Tags: J Nephrol Source Type: research

The connection between neurosciences and dialysis: a quick neurological assessment for hemodialysis nurses.
This article highlights the significance of neurovascular disease in persons who receive renal replacement therapy, and serves as an educational review for dialysis nurses to increase their neurological functional assessment skills. The outlined abbreviated neurological assessment parallels the Canadian Neurological Scale, and is based on the practice recommendations published in the RNAO Nursing Best Practice Guidelines in 2005. PMID: 24344519 [PubMed - in process]
Source: CANNT Journal - July 1, 2013 Category: Urology & Nephrology Authors: McCallum C, Leonard M Tags: CANNT J Source Type: research