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Condition: Hemorrhagic Stroke
Therapy: Dialysis

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Total 167 results found since Jan 2013.

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

Clinical Experience of Life-Threatening Dabigatran-Related Bleeding at a Large, Tertiary Care, Academic Medical Center: a Case Series.
CONCLUSION: Reversal strategies for dabigatran-related bleeding events at our institution are highly variable. Intracranial hemorrhage in patients on dabigatran was associated with 43 % mortality. Patients with severe dabigatran-related bleeding may benefit from a standardized approach to treatment. PMID: 24385325 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - January 3, 2014 Category: Toxicology Authors: Ross B, Miller MA, Ditch K, Tran M Tags: J Med Toxicol 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

Risk of Stroke in Long-term Dialysis Patients Compared With the General Population
Conclusions: Patients undergoing dialysis are at elevated risk of stroke. Patients undergoing PD appear to be less likely to develop hemorrhagic stroke than those undergoing HD. Comprehensive control of hypertension and diabetes is necessary when delivering dialysis treatment.
Source: American Journal of Kidney Diseases - December 2, 2013 Category: Urology & Nephrology Authors: Hsi-Hao Wang, Shih-Yuan Hung, Junne-Ming Sung, Kuan-Yu Hung, Jung-Der Wang Tags: Dialysis Source Type: research

More Studies Required to Understand Mortality Rates of Dialysis-Dependent Patients after Acute Thrombolysis for Stroke
I read with interest the article by Tariq et al in the Journal that details outcomes with thrombolytic therapy for acute ischemic stroke in over 1000 dialysis patients. They are to be commended for examining this important aspect of acute stroke care in dialysis cohorts. However, in their discussion, the authors state that a previous US study by Sozio et al reported a 30-day mortality rate of 35% after thrombolysis. This is inaccurate and can potentially cause confusion. In fact, careful review of the article reveals that the authors of that study do not report any thrombolysis-related outcomes and that this mortality ra...
Source: Journal of Stroke and Cerebrovascular Diseases - July 1, 2013 Category: Neurology Authors: Albert Power Tags: Letters to the Editor Source Type: research

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

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

Cerebrorenal interaction and stroke.
Abstract Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microb...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Toyoda K Tags: Contrib Nephrol Source Type: research

Stroke feature and management in dialysis patients.
Abstract Strokes remain the major complication among dialysis population as the number of diabetes and elderly is increasing. In chronic hemodialysis patients, prevalence and incidence of stroke is higher than that of the general population. According to the annual registry data of the Japanese Society for Dialysis Therapy, prevalence of stroke death has been declining, yet the incidence of nonfatal incidence of stroke is not known. Underlying mechanisms of stroke are multiple. Among them, control of hypertension is important for the primary prevention; however, the ideal target level of blood pressure is not dete...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Iseki K Tags: Contrib Nephrol Source Type: research

The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study.
Conclusions With this controlled crossover study, the authors provide the pilot evidence that both SLED and CVVH display identical acute hemodynamic effects and increased ICP after dialysis in brain hemorrhage patients. Clinical trial registration no.: NCT01781585 ( ClinicalTrials.gov ). PMID: 23706048 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - May 24, 2013 Category: Neurosurgery Authors: Wu VC, Huang TM, Shiao CC, Lai CF, Tsai PR, Wang WJ, Huang HY, Wang KC, Ko WJ, Wu KD, NSARF Group Tags: J Neurosurg 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

Outcomes of Thrombolytic Treatment for Acute Ischemic Stroke in Dialysis-Dependent Patients in the United States
Conclusions: The 2-fold higher odds of in-hospital mortality associated with administration of IV thrombolytics in dialysis-dependent patients who present with acute ischemic stroke warrant a careful assessment of risk–benefit ratio in this population.
Source: Journal of Stroke and Cerebrovascular Diseases - April 30, 2013 Category: Neurology Authors: Nauman Tariq, Malik M. Adil, Fahad Saeed, Saqib A. Chaudhry, Adnan I. Qureshi Tags: Original Articles Source Type: research

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

Transapical aortic valve replacement in extreme-risk patients: outcome, risk factors and mid-term results ADULT CARDIAC
CONCLUSIONS TA-TAVR in extreme-risk patients carries a moderate risk of hospital mortality. Severe comorbidities and presence of residual paravalvular leakages affect the mid-term survival, whereas surviving patients have an acceptable quality of life without rehospitalizations for cardiac decompensation.
Source: European Journal of Cardio-Thoracic Surgery - April 8, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Ferrari, E., Namasivayam, J., Marcucci, C., Gronchi, F., Berdajs, D., Niclauss, L., von Segesser, L. K. Tags: ADULT CARDIAC Source Type: research

Low serum fetuin A levels and incident stroke in patients with maintenance haemodialysis
ConclusionsFetuin A deficiency is associated with a higher risk of incident stroke among prevalent HD patients.
Source: European Journal of Clinical Investigation - February 19, 2013 Category: Journals (General) Authors: Hung‐Yuan Chen, Yen‐Ling Chiu, Shih‐Ping Hsu, Mei‐Fen Pai, Ju‐Yeh Yang, Yu‐Sen Peng Tags: Original Article Source Type: research