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Atrial fibrillation and risk of stroke in dialysis patients
Abstract: Purpose: Both stroke and chronic atrial fibrillation (AF) are common in dialysis patients, but uncertainty exists in the incidence of new strokes and the risk conferred by chronic AF.Methods: A cohort of dually eligible (Medicare and Medicaid) incident dialysis patients was constructed. Medicare claims were used to determine the onset of chronic AF, which was specifically treated as a time-dependent covariate. Cox proportional hazards models were used to model time to stroke.Results: Of 56,734 patients studied, 5629 (9.9%) developed chronic AF. There were 22.8 ischemic and 5.0 hemorrhagic strokes per 1000 patient...
Source: Annals of Epidemiology - January 18, 2013 Category: Epidemiology Authors: James B. Wetmore, Edward F. Ellerbeck, Jonathan D. Mahnken, Milind Phadnis, Sally K. Rigler, Purna Mukhopadhyay, John A. Spertus, Xinhua Zhou, Qingjiang Hou, Theresa I. Shireman Source Type: research

Meta-Analysis of Anticoagulation Use, Stroke, Thromboembolism, Bleeding, and Mortality in Patients With Atrial Fibrillation on Dialysis
Atrial fibrillation (AF) is common in patients on dialysis. Although randomized trials of anticoagulation for AF have demonstrated striking reductions in stroke, these trials did not recruit patients on dialysis. We thus undertook this systematic review and meta-analysis of observational studies including patients with AF on dialysis that reported associations of anticoagulation use. Twenty studies involving 529,741 subjects and 31,321 patients with AF on dialysis were identified. Anticoagulation was associated with a 45% (95% CI 13% to 88%) increased risk of any stroke, reflecting a nonsignificant 13% (95% CI −4% to 34...
Source: The American Journal of Cardiology - April 12, 2016 Category: Cardiology Authors: Christopher X. Wong, Ayodele Odutayo, Connor A. Emdin, Ned J. Kinnear, Michelle T. Sun Tags: Arrhythmias and Conduction Disturbances Source Type: research

Hemorrhagic Stroke in Chronic Kidney Disease.
Authors: Jha VK, Sharda V, Mirza SA, Shashibhushan, Bhol KK Abstract Hemorrhagic stroke is leading cause of death in Chronic Kidney Disease (CKD) population. Uremic patients are susceptible to hemorrhagic complications due to multiple reasons i.e platelet dysfunction, low platelet number, use of heparin during hemodialysis, use of anticoagulants for thromboembolic risk etc. Prevention and treatment of hemorrhagic stroke is complicated in CKD setting and if not managed properly can lead to several fold increased mortality and morbidity rate. In this brief review we will discuss about the magnitude of hemorrhagic str...
Source: Journal of the Association of Physicians of India - July 18, 2019 Category: General Medicine Tags: J Assoc Physicians India Source Type: research

Difficulty of stroke management in the dialysis child
ConclusionCause or consequences of the renal disease, HT must be properly treated in order to reach the recommended targeted blood pressure values. The time required to take charge the hypertensive stroke determines the prognosis. The challenge is to optimize the health care sector to reduce mortality and sequelae.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 Category: Cardiology Source Type: research

Difference in stroke incidence between Korean and Japanese patients initiating dialysis — era or ethnic effect?
We thank Tomoyuki Kawada for the letter in response to our recent article [1]. First, we would like to focus on the differences in epidemiologic characteristics of stroke between our study population and those enrolled in a previous study conducted in Japan [2]. As indicated, the main difference in the findings between the two studies was that the proportion of hemorrhagic stroke among the total stroke events was substantially higher in the Japanese study than in our study (52% vs. 21%). Although the definite reasons for this difference remain uncertain, adding to the possible association kindly suggested by Kawada, some s...
Source: International Journal of Cardiology - September 18, 2015 Category: Cardiology Authors: Hyunwook Kim, Dong-Ryeol Ryu Tags: Correspondence 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

Hemoglobin Concentration and Stroke Risk in Hemodialysis Hemoglobin Concentration and Stroke Risk in Hemodialysis
Might low hemoglobin concentrations contribute to the risk for hemorrhagic or ischemic stroke among hemodialysis patients?Nephrology Dialysis Transplantation
Source: Medscape Today Headlines - June 13, 2018 Category: Consumer Health News Tags: Nephrology Journal Article Source Type: news

Response to the Letter by Tariq
We stated in our discussion section that “A previous study16 reported 35% mortality within 30 days of IV rt-PA treatment in dialysis dependent renal failure patients.” The mention of IV rt-PA in these patients is a mistake on our part. The 35% mortality within 30 days reported by Sozio et al was reported for all stroke subtypes including hemorrhagic strokes. The following study does not mention if IV rt-PA was administered or not in these patients.
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2013 Category: Neurology Authors: Nauman Tariq, Adnan I. Qureshi Tags: Letters to the Editor Source Type: research

Nontraumatic Subarachnoid Hemorrhage in Maintenance Dialysis Hospitalizations: Trends and Outcomes Clinical Sciences
Conclusions— SAH hospitalizations are more common and associated with higher mortality in patients on maintenance dialysis than in the general population. Although being on maintenance dialysis is an independent predictor for mortality in patients with SAH, other predictors of mortality evaluated in this study are not necessarily different between the 2 groups.
Source: Stroke - December 23, 2013 Category: Neurology Authors: Sakhuja, A., Schold, J. D., Kumar, G., Katzan, I., Navaneethan, S. D. Tags: Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage Clinical Sciences Source Type: research

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran
Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not ‘routine’. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated p...
Source: Emergency Medicine Journal - January 15, 2014 Category: Emergency Medicine Authors: Alikhan, R., Rayment, R., Keeling, D., Baglin, T., Benson, G., Green, L., Marshall, S., Patel, R., Pavord, S., Rose, P., Tait, C. Tags: Poisoning/Injestion, Open access, Drugs: cardiovascular system, Stroke, Poisoning Review Source Type: research

Neurological Involvement in Primary Systemic Vasculitis
Conclusion Neurological involvement is a common complication of PSV (Table 1), and neurologists play an important role in the identification and diagnosis of PSV patients with otherwise unexplained neurological symptoms as their chief complaint. This article summarizes the neurological manifestations of PSV and hopes to improve neuroscientists' understanding of this broad range of diseases. TABLE 1 Table 1. Common CNS and PNS involvements of primary systemic vasculitis. Author Contributions SZ conceived the article and wrote the manuscript. DY and GT reviewed and edited the manuscript. All authors ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

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

New aspects of cerebrovascular diseases in dialysis patients.
Authors: Naganuma T, Takemoto Y Abstract Growing evidence suggests that chronic kidney disease is a significant risk factor for stroke, subclinical cerebrovascular abnormalities, and cognitive impairment, independent of known cardiovascular risk factors. Cerebrovascular disease is also a major cause of death in dialysis patients, who have a much higher incidence of stroke compared to the normal population. Strokes in dialysis patients are also characterized by a higher incidence of hypertensive intracerebral hemorrhage compared with those in the general population. Recent studies on dialysis cohorts have shown that...
Source: Contributions to Nephrology - June 1, 2015 Category: Urology & Nephrology Tags: Contrib Nephrol 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

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