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Condition: Ischemic Stroke
Therapy: Dialysis

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Total 281 results found since Jan 2013.

Progeria syndrome in CKD/ESRD
Conclusions: Renal impairment independently associates with greater stroke disability at presentation and worse functional outcomes despite modern stroke care. Nonetheless these patients are also less likely to be thrombolysed for acute ischaemic stroke, which suggests a possible inequity in access to healthcare that requires urgent study.
Source: Nephrology Dialysis Transplantation - May 10, 2013 Category: Urology & Nephrology Authors: Power, A., Gill, D., Wietek, N., Lim, J., Tanna, R., Duncan, N., Troyano Suarez, N., Del Nogal Avila, M., Mora Valenciano, I., Olmos Centenero, G., Diez-Marques, M. L., Cortes, M., Lopez Ongil, S., Martin Sanchez, P., Rodriguez Puyol, D., Ruiz Torres, M. Tags: Abstracts 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

Effectiveness and Safety of Warfarin in Dialysis Patients With Atrial Fibrillation: A Meta-Analysis of Observational Studies
The objective of this study was to assess the effectiveness and safety of warfarin use in patients with AF undergoing dialysis. Three databases PubMed, EMBASE, and OVID were searched from their inception to August 2015. Observational studies which assessed the ischemic stroke or bleeding risk of warfarin use in dialysis patients with AF were included. Two reviewers independently extracted data and assessed methodological quality based on the Newcastle–Ottawa Scale score. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model and heterogeneity was assessed based...
Source: Medicine - December 1, 2015 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research

Valvular calcification upon initiating dialysis predict the appearance of cardiovascular events in patient evolution.
CONCLUSIONS: The prevalence of VC at the commencement of dialysis is very high and its presence is an independent predictor of event and cardiovascular mortality presentation in the course of follow-up. PMID: 26300509 [PubMed - as supplied by publisher]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - August 25, 2015 Category: Urology & Nephrology Tags: Nefrologia 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

Amelioration of ischemic brain damage by peritoneal dialysis
Ischemic stroke is a devastating condition, for which there is still no effective therapy. Acute ischemic stroke is associated with high concentrations of glutamate in the blood and interstitial brain fluid. The inability of the tissue to retain glutamate within the cells of the brain ultimately provokes neuronal death. Increased concentrations of interstitial glutamate exert further excitotoxic effects on healthy tissue surrounding the infarct zone. We developed a strategy based on peritoneal dialysis to reduce blood glutamate levels, thereby accelerating brain-to-blood glutamate clearance. In a rat model of stroke, this ...
Source: Journal of Clinical Investigation - September 9, 2013 Category: Biomedical Science Authors: María del Carmen Godino, Victor G. Romera, José Antonio Sánchez-Tomero, Jesus Pacheco, Santiago Canals, Juan Lerma, José Vivancos, María Angeles Moro, Magdalena Torres, Ignacio Lizasoain, José Sánchez-Prieto 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

Apixaban versus No Anticoagulation in Patients Undergoing Long-Term Dialysis with Incident Atrial Fibrillation.
CONCLUSIONS: In patients with kidney failure and nonvalvular atrial fibrillation, treatment with apixaban was not associated with a lower incidence of new stroke, transient ischemic attack, or systemic thromboembolism but was associated with a higher incidence of fatal or intracranial bleeding. PMID: 32444398 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 21, 2020 Category: Urology & Nephrology Authors: Mavrakanas TA, Garlo K, Charytan DM Tags: Clin J Am Soc Nephrol 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

Branch-first continuous perfusion aortic arch replacement. Insight into our results
CONCLUSIONS: BF-CPAR is safe and adds to the armamentarium of Aortic Arch Repair. In elective and uncomplicated acute-dissection cases, it has no mortality and low stroke (1.9%), and vital organ dysfunction risk. Its results which are comparable to many of the best currently reported series, is driven by avoidance of cerebral circulatory arrest and reduction of cardiac and visceral ischemic time.PMID:35238522 | DOI:10.23736/S0021-9509.22.12272-X
Source: The Journal of Cardiovascular Surgery - March 3, 2022 Category: Cardiovascular & Thoracic Surgery Authors: George Matalanis Varun J Sharma Source Type: research