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Drug: Warfarin
Therapy: Dialysis
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Total 159 results found since Jan 2013.
Case report: hemodialysis for dabigatran overdose
3 out of 5 stars
Hemodialysis for the Treatment of Pulmonary Hemorrhage from Dabigatran Overdose. Chen BC et al. Am J Kidney Dis 2013 Apr 15 [Epub ahead of print]
Abstract
Dabigatran (Pradaxa) is a competitive direct thrombin inhibitor approved in the United States for stroke prophylaxis in patients with nonvalvular atrial fibrillation. Although dabigatran has certain advantages over coumadin related to issues of dosing and testing, there is no readily available test to measure its anticoagulation effect, and there is no antidote to reverse bleeding.
Recommendations for treating a patient with dabigatran-associated hemorr...
Source: The Poison Review - April 24, 2013 Category: Toxicology Authors: Leon Tags: Medical dabigatran hemodialysis hemorrhage overdose Source Type: news
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
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 clinic...
Source: Seminars in Dialysis - January 1, 2014 Category: Urology & Nephrology Authors: Krüger T, Floege J Tags: Semin Dial Source Type: research
Stroke Rounds: Warfarin No Help for Dialysis Patients
(MedPage Today) -- The risk-benefit balance did not appear to be favorable for warfarin in patients with atrial fibrillation who were undergoing dialysis, a retrospective study showed.
Source: MedPage Today Neurology - March 25, 2014 Category: Neurology Source Type: news
AF News
This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - March 1, 2014 Category: Cardiology Authors: TZE‐FAN CHAO, LI‐WEI LO, SHIH‐ANN CHEN Tags: AF News Source Type: research
The last reprogramming
Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine.
By Westby G. Fisher, MD, FACC
He had called the other day to update me up on his condition. He did not sound upset, but resolute. "They offered me peritoneal dialysis," he said, "but I decided against it and figured I'd just let nature take its course. The hospice people are so wonderful - I've got things all set here at home, but I ha...
Source: Mass Device - September 29, 2014 Category: Medical Equipment Authors: MassDevice Tags: Dr. Wes Source Type: news
Management of Bleeding Complications in Patients Taking Direct Oral Anticoagulants at a Large Tertiary Academic Medical Center
Abstract
Direct oral anticoagulants (DOACs) offer a fixed-dose alternative to warfarin for stroke prevention in patients with atrial fibrillation. However, there is minimal evidence to guide the management of bleeding in patients taking a DOAC. We retrospectively evaluated the acute management of major bleeding in this patient population at a large, tertiary academic medical center. We evaluated various strategies of management including dialysis, transfusions, pharmacologic agents, surgical intervention, and reinitiation of anticoagulation. We also assessed length of intensive care unit and hospital stay, mor...
Source: Current Emergency and Hospital Medicine Reports - June 13, 2015 Category: Emergency Medicine Source Type: research
Challenging the use of warfarin in patients on dialysis with atrial fibrillation
Nature Reviews Nephrology 11, 450 (2015).
doi:10.1038/nrneph.2015.87
Authors: Georg Schlieper & Jürgen Floege
We read with great interest the article from Qamar and Bhatt (Anticoagulation therapy: Balancing the risks of stroke and bleeding in CKD. Nat. Rev. Nephrol.11, 200–202; 2015) that discussed the observational study by Bonde et al. on anticoagulation
Source: Nature Reviews Nephrology - July 7, 2015 Category: Urology & Nephrology Authors: Georg SchlieperJürgen Floege Tags: Correspondence Source Type: research
Clinical Benefit of Warfarin in Dialysis Patients With Atrial Fibrillation
Patients with atrial fibrillation (AF) and end-stage chronic kidney disease (CKD) receiving dialysis are at higher risk of stroke (1). Warfarin has been shown to reduce the frequency of strokes by 64.0% in patients with AF; however, its use in dialysis patients has not received consensus owing to the lack of randomized controlled trial data and associated increased bleeding risk.
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology 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
Safety of warfarin therapy in chronic hemodialysis patients: a prospective cohort study
Conclusion
The results of this study suggested that warfarin use by HD patients might not be harmful in chronic state, while the safety for the initiation of warfarin therapy in HD patients remained to be determined.
Source: Clinical and Experimental Nephrology - December 1, 2015 Category: Urology & Nephrology Source Type: research
The Effect of Cardiopulmonary Bypass on Dabigatran Levels
DABIGATRAN IS a novel anticoagulant that is licensed for use for the prevention of stroke in the presence of atrial fibrillation. Its use has expanded rapidly in New Zealand, primarily due to there being no requirement for routine monitoring of its effect, as there is for warfarin. There are case reports in the literature describing management of patients coming for urgent cardiac surgery, which revolve mainly around the use of dialysis and massive transfusion of clotting factors to manage the bleeding associated with surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 31, 2015 Category: Anesthesiology Authors: Kelly Byrne Tags: CASE REPORT Source Type: research
Patients' Characteristics Affect the Survival Benefit of Warfarin Treatment for Hemodialysis Patients with Atrial Fibrillation. A Historical Cohort Study
Background: Stroke prevention in dialysis-dependent patients with atrial fibrillation (AF) is an unresolved clinical dilemma. Indeed, no randomized controlled trial evaluating the efficacy and safety of oral anticoagulants in this population, has been conducted so far. Observational research on the use of warfarin in patients on dialysis has shown conflicting results. This uncertainty is mirrored by the wide variations in warfarin prescription patterns across centers. We sought to evaluate the association between the use of vitamin K antagonists (VKAs) and mortality among hemodialysis patient with AF and to assess potentia...
Source: American Journal of Nephrology - September 6, 2016 Category: Neurology Source Type: research
Warfarin Initiation, Atrial Fibrillation, and Kidney Function: Comparative Effectiveness and Safety of Warfarin in Older Adults With Newly Diagnosed Atrial Fibrillation
Conclusions Among older adults with AF, warfarin therapy initiation was associated with a significantly lower 1-year risk for the composite outcome across all strata of kidney function. The risk for major bleeding associated with warfarin use was increased only among those with eGFRs of 60 to 89mL/min/1.73m2.
Source: American Journal of Kidney Diseases - December 18, 2016 Category: Urology & Nephrology Source Type: research
