• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 2
<span class="paragraphSection">The choice of oral anticoagulant (OAC) for patients with atrial fibrillation (AF) may be influenced by individual clinical features or by patterns of risk factors and comorbidities. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. non-vitamin K oral anticoagulants (NOACs) for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In addition, we discuss the timing of initiation of anticoagulation. In the second of a two-part review, we discuss the use of NOAC for stroke prevent...
Source: European Heart Journal - February 4, 2016 Category: Cardiology 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

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

Cardiovascular and renal outcomes in patients with atrial fibrillation and stage 4 –5 chronic kidney disease receiving direct oral anticoagulants: a multicenter retrospective cohort study
AbstractThe role of direct oral anticoagulants (DOAC) in patients with atrial fibrillation (AF) and stage 4 –5 chronic kidney disease (CKD) is controversial. Electronic medical records from 2012 to 2021 were retrieved for patients with AF and stage 4–5 CKD receiving oral anticoagulants. Patients were separated into those receiving DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) or vitamin K ant agonists (VKA). Primary outcomes included ischemic stroke (IS), systemic thrombosis (SE), major bleeding, gastrointestinal bleeding, hemorrhagic stroke, acute myocardial infarction, cardiovascular death, and all-cause dea...
Source: Journal of Thrombosis and Thrombolysis - August 21, 2023 Category: Hematology Source Type: research

Atrial fibrillation in dialysis patients: is there a place for non-vitamin K antagonist oral anticoagulants?
AbstractAtrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin. Nevertheless according to ESC guidelines, NOACs are not recommended in p...
Source: International Urology and Nephrology - May 21, 2018 Category: Urology & Nephrology Source Type: research

Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines.
Authors: Młodawska E, Tomaszuk-Kazberuk A, Łopatowska P, Musiał WJ, Małyszko J Abstract Atrial fibrillation (AF) frequently occurs in patients with chronic kidney disease (CKD), and the rate reaches even 30% in patients with end-stage renal disease (ESRD). Patients with AF and CKD have a significantly higher risk of thrombotic complications, particularly ischemic stroke, and at the same time, a higher bleeding risk (proportionally to the grade of renal failure). In addition, AF and CKD share a number of comorbidities and risk factors, which results in increased mortality rates. Moreover, disturbances in hemosta...
Source: Polskie Archiwum Medycyny Wewnetrznej - June 2, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Mediacalcosis in hemodialysis, predictors and prognosis
ConclusionMediacalcosis is a severe complication since it increases the risk of cardiovascular morbidity and mortality in hemodialysis patients, to this end, the individualization of entangled factors involved in its pathophysiology, will slow down or prevent its progression in the future.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 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

Systematic DOACs oral anticoagulation in patients with atrial fibrillation and chronic kidney disease: the nephrologist's perspective.
Abstract Atrial fibrillation (AF) is highly prevalent among patients with chronic kidney disease (CKD), and also associated with unfavorable outcome. Anticoagulant therapy is the mainstep of management in such patients, aimed at reducing the high risk of systemic thromboembolism and especially of ischemic stroke, which is reportedly associated with increased mortality in CKD patients. Even though new direct oral anticoagulant agents (DOACs) proved to be effective in patients with non valvular chronic AF, and are therefore recommended by recent guidelines for their treatment, warfarin is currently used in more than...
Source: Journal of Nephrology - March 20, 2020 Category: Urology & Nephrology Authors: Ravera M, Bussalino E, Fusaro M, Di Lullo L, Aucella F, Paoletti E Tags: J Nephrol Source Type: research