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Association Between Serum Phosphate Levels and Stroke Risk in Patients Undergoing Hemodialysis: The Q-Cohort Study Clinical Sciences
Conclusions— Higher serum phosphate levels were associated with an increased risk of brain hemorrhage, whereas low levels were associated with an increased risk of brain infarction in hemodialysis patients. These results suggest the importance of managing serum phosphate levels within an appropriate range in hemodialysis patients. Clinical Trial Registration— URL: http://www.umin.ac.jp/. Unique identifier: UMIN000000556.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Yamada, S., Tsuruya, K., Taniguchi, M., Tokumoto, M., Fujisaki, K., Hirakata, H., Fujimi, S., Kitazono, T. Tags: Cardiovascular Disease, Epidemiology, Risk Factors, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research

Cerebrovascular Accidents During Mechanical Circulatory Support Clinical Sciences
Conclusions—Stroke is a major cause of morbidity and mortality in patients on LVAD support. Chronic obstructive pulmonary disease increases the risk of ischemic stroke, whereas dialysis may increase the risk of hemorrhagic stroke. Although any stroke increases mortality, post-LVAD hemorrhagic stroke was associated with higher mortality compared with ischemic stroke.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Saef Izzy, Daniel B. Rubin, Firas S. Ahmed, Feras Akbik, Simone Renault, Katelyn W. Sylvester, Henrikas Vaitkevicius, Jennifer A. Smallwood, Michael M. Givertz, Steven K. Feske Tags: Heart Failure, Complications, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Renal Dysfunction Is Associated With Poststroke Discharge Disposition and In-Hospital Mortality Clinical Sciences
Background and Purpose—Kidney disease is a frequent comorbidity in patients presenting with acute ischemic stroke. We evaluated whether the estimated glomerular filtration rate (eGFR) on admission is associated with poststroke in-hospital mortality or discharge disposition.Methods—In this cohort study, data from ischemic stroke patients in Get With The Guidelines–Stroke linked to fee-for-service Medicare data were analyzed. The Modification of Diet in Renal Disease study equation was used to calculate the eGFR (mL/min/1.73 m2). Dialysis was identified by International Classification of Diseases, Ninth Revision codes....
Source: Stroke - January 22, 2017 Category: Neurology Authors: Nada El Husseini, Gregg C. Fonarow, Eric E. Smith, Christine Ju, Lee H. Schwamm, Adrian F. Hernandez, Phillip J. Schulte, Ying Xian, Larry B. Goldstein Tags: Mortality/Survival, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Warfarin Use in Patients With Atrial Fibrillation Undergoing Hemodialysis Clinical Sciences
Conclusions—Our findings suggest that warfarin should be used carefully in hemodialysis patients, given the higher risk of hemorrhagic events and the lack of ability to prevent thromboembolic complications.
Source: Stroke - August 28, 2017 Category: Neurology Authors: Chang-Yun Yoon, Juhwan Noh, Jong Hyun Jhee, Tae Ik Chang, Ea Wha Kang, Youn Kyung Kee, Hyoungnae Kim, Seohyun Park, Hae-Ryong Yun, Su-Young Jung, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Changsoo Kim, Tae-Hyun Yoo Tags: Arrhythmias, Clinical Studies, Nephrology and Kidney, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Risk Factors and Outcomes of Cerebral Stroke in End-Stage Renal Disease Patients Receiving Hemodialysis
This study investigated the stroke features and risk factors in hemodialysis (HD) patients. Methods: All end-stage renal disease patients undergoing HD at Teraoka Memorial Hospital dialysis center were identified, with 195 recruited. Baseline clinical characteristics were collected, and the clinical outcomes and related factors of stroke in HD patients were retrospectively analyzed.
Source: Journal of Stroke and Cerebrovascular Diseases - February 5, 2020 Category: Neurology Authors: Yuki Shinya, Satoru Miyawaki, Isao Kumagai, Takehiro Sugiyama, Atsumi Takenobu, Nobuhito Saito, Akira Teraoka 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

Dialysis Requiring Acute Kidney Injury in Acute Cerebrovascular Accident Hospitalizations Clinical Sciences
Conclusions— Incidence of AKI-D complicating hospitalizations with cerebrovascular accident continues to grow and is associated with increased mortality and adverse discharge. This highlights the need for early diagnosis, better risk stratification, and preparedness for need for complex long-term care in this vulnerable population.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Nadkarni, G. N., Patel, A. A., Konstantinidis, I., Mahajan, A., Agarwal, S. K., Kamat, S., Annapureddy, N., Benjo, A., Thakar, C. V. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Acute Stroke Syndromes Clinical Sciences Source Type: research

Risk Factors for Stroke in People with End-Stage Kidney Disease: A Cohort Study
Conclusions: These findings could be used to establish reliable estimates of the risk of stroke in people with ESKD and identify those who are most likely to benefit from preventive treatments.Cerebrovasc Dis 2016;42:428-438
Source: Cerebrovascular Diseases - August 9, 2016 Category: Neurology Source Type: research

Association of Dyskalemias with Ischemic Stroke in Advanced Chronic Kidney Disease Patients Transitioning to Dialysis
Conclusion: In patients with advanced CKD, hypokalemia (chronic exposure) was associated with a higher risk of ischemic stroke, whereas hyperkalemia (acute exposure) was associated with a lower risk of ischemic stroke. Further studies in this population are needed to explore the mechanisms underlying these associations.Am J Nephrol
Source: American Journal of Nephrology - July 21, 2021 Category: Neurology Source Type: research

Primary Prevention of Stroke in Chronic Kidney Disease Patients: A Scientific Update
Background: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking.Summary: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population. The use of oral anticoagulation in AF appears safe...
Source: Cerebrovascular Diseases - January 9, 2018 Category: Neurology Source Type: research

Comparison of Clevidipine and Nicardipine for Acute Blood Pressure Reduction in Hemorrhagic Stroke
ConclusionsIn patients with hemorrhagic stroke, nicardipine appeared to have similar efficacy as clevidipine in SBP reduction, with a more likely reduction of rebound hypertension and drug cost. This retrospective study was underpowered, which may limit these implications. Further prospective studies are warranted to confirm these results.
Source: Neurocritical Care - December 13, 2021 Category: Neurology Source Type: research

Variables affecting Stroke Outcome for TPA received between 3 to 4.5 hours (P2.301)
Conclusions: Age, NIHSS and renal dysfunction were significantly associated with worse outcome in patients who had received t-PA between 3 to 4.5 hours. Our findings were consistent but more robust than previous studies showing poorer outcome with renal dysfunction (Meta-analysis OR1.06 NS). After controlling for age and NIHSS, diabetes or hypertension did not additionally contribute to poor outcome. Prognostic and risk stratification scales are useful as predictors of outcome but do not imply efficacy of t-PA therapy or lack thereof.Disclosure: Dr. Yeo has nothing to disclose. Dr. McCane has nothing to disclose. Dr. Katz ...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Yeo, C., McCane, D., Katz, L., Ling, K., Capetillo, A., Bledsoe, D., Chiu, D. Tags: Acute Therapy: IV t-PA Source Type: research

Neuroprotection in acute stroke: targeting excitotoxicity, oxidative and nitrosative stress, and inflammation
Publication date: Available online 11 May 2016 Source:The Lancet Neurology Author(s): Ángel Chamorro, Ulrich Dirnagl, Xabier Urra, Anna M Planas Treatments for acute ischaemic stroke continue to evolve after the superior value of endovascular thrombectomy was confirmed over systemic thrombolysis. Unfortunately, numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischaemic stroke, making the search for new treatments imperative. Increased awareness of the relevance of rigorous preclinical testing, and appropriate selection of study participants, might overcome the barriers to progress...
Source: The Lancet Neurology - May 11, 2016 Category: Neurology 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

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

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