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Condition: Ischemic Stroke
Procedure: Dialysis
Therapy: Dialysis

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Total 281 results found since Jan 2013.

Evidence for the Prevention and Treatment of Stroke in Dialysis Patients
Abstract The risks of both ischemic and hemorrhagic stroke are particularly high in dialysis patients of any age and outcomes are poor. It is therefore important to identify strategies that safely minimize stroke risk in this population. Observational studies have been unable to clarify the relative importance of traditional stroke risk factors such as blood pressure and cholesterol in those on dialysis, and are affected by biases that usually make them an inappropriate source of data on which to base therapeutic decisions. Well‐conducted randomized trials are not susceptible to such biases and can reliably investigate t...
Source: Seminars In Dialysis - May 1, 2014 Category: Hematology Authors: William Herrington, Richard Haynes, Natalie Staplin, Jonathan Emberson, Colin Baigent, Martin Landray Tags: Review Source Type: research

Acute Renal Failure Is Associated With Higher Death and Disability in Patients With Acute Ischemic Stroke: Analysis of Nationwide Inpatient Sample Brief Reports
Conclusions— ARF in patients with AIS is associated with significantly higher rates of moderate to severe disability at discharge and in-hospital mortality.
Source: Stroke - April 28, 2014 Category: Neurology Authors: Saeed, F., Adil, M. M., Khursheed, F., Daimee, U. A., Branch, L. A., Vidal, G. A., Qureshi, A. I. Tags: Acute Cerebral Infarction Brief Reports Source Type: research

Ischemic and Hemorrhagic Stroke: High Incidence in Hemodialysis and Peritoneal Dialysis Patients
Related Article, p. 604
Source: American Journal of Kidney Diseases - March 27, 2014 Category: Urology & Nephrology Authors: David A. Drew, Mark J. Sarnak Tags: Editorials Source Type: research

Effectiveness and safety of antiplatelet in stroke patients with end‐stage renal disease undergoing dialysis
ConclusionsAntiplatelet therapy, especially aspirin, still offers safe and effective treatment for ischemic stroke prevention in patients with end‐stage renal disease undergoing dialysis.
Source: International Journal of Stroke - February 1, 2014 Category: Neurology Authors: Chung‐Yu Chen, Kun‐Tai Lee, Charles Tzu‐Chi Lee, Wen‐Ter Lai, Yaw‐Bin Huang Tags: Research Source Type: research

Race, Ethnicity, and State-by-State Geographic Variation in Hemorrhagic Stroke in Dialysis Patients.
CONCLUSION: Race and ethnicity, or other factors that covary with these, appear to explain a substantial portion of state-by-state geographic variation in hemorrhagic stroke. This finding suggests that the factors underlying the high rate of hemorrhagic strokes in dialysis patients are likely to be system-wide and that further investigations into regional variations in clinical practices are unlikely to identify large opportunities for preventive interventions for this disorder. PMID: 24458073 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - January 23, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Mahnken JD, Ellerbeck EF, Rigler SK, Zhou X, Shireman TI Tags: Clin J Am Soc Nephrol 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

Black Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
Objective: In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery.Design: Retrospective observational study.Setting: Single center, regional hospital.Participants: A total of 1,309 cardiac surgical patients (78.1% coronary bypass, 28.0% valve) treated between 2006 and 2012.Interventions: A total of 488 of these patie...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 13, 2013 Category: Anesthesiology Authors: Lisa Oliveri, Katie Jerzewski, Alexander Kulik Tags: Original Articles Source Type: research

Statins in patients with CKD prove beneficial in reducing cardiovascular events and mortality but show no benefit in patients on dialysis
Commentary on: Palmer SC, Craig JC, Navaneethan SD, et al.. Benefits and harms of statin therapy for persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med 2012;157:263–75. Context High-quality evidence suggests that chronic kidney disease (CKD) should now be considered a coronary heart disease (CHD) risk equivalent. Although statin therapy consistently reduces coronary events in the general population, the clinical benefits of lipid lowering in persons with CKD are less certain. Although multiple studies have shown possible benefit from statin therapy in early-stage CKD patients, ...
Source: Evidence-Based Medicine - September 19, 2013 Category: Internal Medicine Authors: Krishnan, S., Jacobson, T. A. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Renal medicine Therapeutics 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

The association of Klotho gene polymorphism with the mortality of patients on maintenance dialysis.
Abstract Despite medical progress, high morbidity and mortality rates have persisted in patients with end-stage renal disease (ESRD). The role in atherosclerosis and cardiovascular disease of klotho, an aging process-related gene, has been highlighted. Genetic variation in klotho has been reported to be a risk factor for coronary artery disease and ischemic stroke. Regarding the significance of cardiovascular disease for the outcome of ESRD patients, we investigated whether genetic variation of klotho was associated with mortality in ESRD patients on hemodialysis. 478 patients on maintenance hemodialysis for more ...
Source: Clinical Nephrology - September 2, 2013 Category: Urology & Nephrology Authors: Ko GJ, Lee YM, Lee EA, Lee JE, Bae SY, Park SW, Park MS, Pyo HJ, Kwon YJ Tags: Clin Nephrol 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

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

Screening for transient ischemic attacks in hemodialysis patients.
Conclusions: Based on the first study of its kind to date, systematic screening for TIA has a low yield and cannot be relied on alone to identify patients at higher risk of cerebrovascular events. The confounding presence of symptoms attributable to uremia, neuropathy, hypotension and dysglycemia could reduce the sensitivity of established tests, with significant implications for the detection and treatment of TIA in dialysis. PMID: 23807647 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - May 23, 2013 Category: Urology & Nephrology Authors: Power A, Edwards C, Sawyer J, Tandaric D, Dahdaleh D, Taube D, Duncan N Tags: J Nephrol Source Type: research

Astrocytic Ca(2+) waves mediate activation of extrasynaptic NMDA receptors in hippocampal neurons to aggravate brain damage during ischemia.
Abstract Excitotoxicity plays a central role in the neuronal damage during ischemic stroke. Although growing evidence suggests that activation of extrasynaptic NMDA receptors initiates the neuronal death, no direct evidence demonstrated their activation during ischemia. Using rat hippocampal slices, we detected oxygen-glucose deprivation (OGD) induced slow inward currents (SICs) mediated by extrasynaptic NMDA receptors in CA1 pyramidal neurons. Moreover, Ca(2+) chelator BAPTA dialysis into astrocytic network decreased the frequency of OGD induced SICs, indicating the activation of extrasynaptic NMDA receptors depe...
Source: Neurobiology of Disease - May 20, 2013 Category: Neurology Authors: Dong QP, He JQ, Chai Z Tags: Neurobiol Dis Source Type: research