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Prognostic Factors for Survival After Extracorporeal Membrane Oxygenation for Cardiogenic Shock
The aim of this study is to examine factors that can predict mortality in patients that have veno-arterial extracorporeal membrane oxygenation (VA-ECMO) instituted for cardiogenic shock. A single-center, retrospective study of 127 patients who underwent VA-ECMO for cardiogenic shock between January 2003 and December 2017 was conducted. Eighty-three (65%) patients survived to weaning or bridging therapy. Complications on VA-ECMO include: hemorrhage (40%), stroke (14%), requirement for dialysis (42%), and limb ischemia (24%). Univariate analysis revealed shorter ECMO duration, higher body mass index, preimplantation creatini...
Source: ASAIO Journal - January 31, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Extrarenal manifestations of the hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli (STEC HUS)
AbstractHemolytic uremic syndrome is commonly caused by Shiga toxin-producingEscherichia coli (STEC). Up to 15% of individuals with STEC-associated hemorrhagic diarrhea develop hemolytic uremic syndrome (STEC HUS). Hemolytic uremic syndrome (HUS) is a disorder comprising of thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury. The kidney is the most commonly affected organ and approximately half of the affected patients require dialysis. Other organ systems can also be affected including the central nervous system and the gastrointestinal, cardiac, and musculoskeletal systems. Neurological complicat...
Source: Pediatric Nephrology - October 29, 2019 Category: Urology & Nephrology Source Type: research

Serum lipoprotein(a) and risk of hemorrhagic stroke among incident peritoneal dialysis patients: a large study from a single center in China.
Conclusions: Among patients with incident PD, a higher serum Lp(a) level may predict a lower risk of hemorrhagic stroke. PMID: 31498021 [PubMed - in process]
Source: Renal Failure - September 10, 2019 Category: Urology & Nephrology Tags: Ren Fail Source Type: research

Peritonitis affects the relationship between low-density lipoprotein cholesterol and cardiovascular events in peritoneal dialysis patients
ConclusionsPD patients with lower baseline LDL-C had a higher risk of peritonitis. The effect of LDL-C on CV events and mortality was different by the presence of peritonitis events.
Source: Canadian Journal of Cardiology - August 30, 2019 Category: Cardiology Source Type: research

Mechanisms of Stroke in Patients with Chronic Kidney Disease.
Abstract BACKGROUND: Given the increasing worldwide prevalence of chronic kidney disease (CKD), it is critical to decrease the associated risk of debilitating vascular complications, including stroke, congestive heart failure, myocardial infarction, and peripheral vascular disease. Treatment options for reducing the risk of all subtypes of stroke in patients with CKD remain limited. For patients with end-stage kidney disease (ESKD), novel applications of noninvasive imaging may help personalize the type of dialysis and dialysis prescription for patients at high-risk. SUMMARY: This manuscript reviews the heigh...
Source: American Journal of Nephrology - August 27, 2019 Category: Urology & Nephrology Authors: Ghoshal S, Freedman BI Tags: Am J Nephrol 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

Cardiac complications in children with chronic renal: Prevalence of risk factors
ConclusionCardiovascular complications are almost constant in hemodialysis children with chronic renal failure strongly related with left ventricular hypertrophy and arterial hypertension. The high risk of mortality related to these cardiac complications makes it essential to have good control of arterial blood pressure and especially a good observance of treatment and regimen in hemodialysis children.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 Category: Cardiology 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

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

Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis.
Conclusion: In early-stage CKD, NOACs had a benefit-risk profile superior to that of VKAs. For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs or NOACs. Primary Funding Source: None. (PROSPERO: CRD42017079709). PMID: 31307056 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - July 15, 2019 Category: Internal Medicine Authors: Ha JT, Neuen BL, Cheng LP, Jun M, Toyama T, Gallagher MP, Jardine MJ, Sood MM, Garg AX, Palmer SC, Mark PB, Wheeler DC, Jha V, Freedman B, Johnson DW, Perkovic V, Badve SV Tags: Ann Intern Med Source Type: research

Comparison of risk of stroke in patients treated with peritoneal dialysis and hemodialysis: a systematic review and meta-analysis.
Conclusions: We observed that PD patients were less likely to develop hemorrhagic stroke than HD patients, and the risk for ischemic stroke was significantly higher for PD patients than for HD patients among the non-Asian patients. However, our findings could be biased due to the heterogeneity of the included studies. PMID: 31296101 [PubMed - in process]
Source: Renal Failure - July 14, 2019 Category: Urology & Nephrology Tags: Ren Fail Source Type: research

Anticoagulation in Patients with Advanced Chronic Kidney Disease: Walking the Fine Line between Benefit and Harm
Publication date: Available online 11 July 2019Source: Canadian Journal of CardiologyAuthor(s): Januvi Jegatheswaran, Gregory L. Hundemer, David Massicotte-Azarniouch, Manish M. SoodAbstractChronic kidney disease affects over 3 million Canadians and is highly associated with cardiovascular diseases that require anticoagulation, such as atrial fibrillation and venous thromboembolism. Patients with chronic kidney disease are at a problematic crossroads; they are at high risk of both thrombotic conditions requiring anticoagulation and bleeding complications due to anticoagulation. The limited high-quality clinical evidence to...
Source: Canadian Journal of Cardiology - July 12, 2019 Category: Cardiology Source Type: research

Warfarin in nonvalvular atrial fibrillation-Time for a change?
Abstract Warfarin is the most commonly prescribed anticoagulant in hemodialysis (HD) patients with nonvalvular atrial fibrillation (NVAF). Recent trends show that Nephrologists are increasingly prescribing novel oral anticoagulants, despite the fact that no randomized clinical trials have been conducted in dialysis patients. Difficulties maintaining international normalized ratio in the therapeutic range, increased risk of intracranial hemorrhage and concerns regarding warfarin-induced vascular calcification and calciphylaxis may be responsible. Anticoagulation quality is poor in HD patients. A variety of factors ...
Source: Seminars in Dialysis - June 16, 2019 Category: Urology & Nephrology Authors: Reilly RF, Jain N Tags: Semin Dial 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

Effect of Warfarin on Ischemic Stroke, Bleeding, and Mortality in Patients with Atrial Fibrillation Receiving Peritoneal Dialysis
ConclusionThere is no significant association between warfarin treatment with risks of mortality, ischemic stroke or bleeding in patients with atrial fibrillation receiving peritoneal dialysis.
Source: American Journal of Cardiovascular Drugs - April 22, 2019 Category: Cardiology Source Type: research

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