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Renal dysfunction is associated with lower odds of home discharge for patients with stroke
CONCLUSION: The odds of home discharge for stroke patients decreased with a significant independent graded association with declining eGFR levels. Renal function could predict home discharge after stroke.PMID:34351833 | DOI:10.1080/00325481.2021.1964198
Source: Postgraduate Medicine - August 5, 2021 Category: Internal Medicine Authors: I-Kuan Wang Tung-Min Yu Tzung-Hai Yen Lu-Ting Chiu Li-Ming Lien Yu Sun Cheng-Yu Wei Kai-Cheng Hsu Ping-Chin Lai Chi-Yuan Li Fung-Chang Sung Chung Y Hsu Source Type: research

Warfarin Use and Risk of Stroke in Patients With Atrial Fibrillation Undergoing Hemodialysis: A Meta-Analysis
Abstract: In spite of the substantial burden of atrial fibrillation and associated elevated ischemic stroke risk in patients undergoing hemodialysis, the role of warfarin in these high-risk patients remains uncertain. Our objective was to clarify the association between warfarin use and risk of stroke for patients with atrial fibrillation undergoing dialysis. PubMed and Embase from January 1966 to January 2015 were searched to identify relevant studies. Inclusion criteria were cohort studies, patients with atrial fibrillation undergoing hemodialysis, and reported quantitative estimates of the multivariate adjusted relativ...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observ Studies in Epidemiology Source Type: research

Effectiveness and Safety of Warfarin in Dialysis Patients With Atrial Fibrillation: A Meta-Analysis of Observational Studies
The objective of this study was to assess the effectiveness and safety of warfarin use in patients with AF undergoing dialysis. Three databases PubMed, EMBASE, and OVID were searched from their inception to August 2015. Observational studies which assessed the ischemic stroke or bleeding risk of warfarin use in dialysis patients with AF were included. Two reviewers independently extracted data and assessed methodological quality based on the Newcastle–Ottawa Scale score. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model and heterogeneity was assessed based...
Source: Medicine - December 1, 2015 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research

Effect of anticoagulation therapy in older patients with chronic kidney disease and atrial fibrillation: A meta-analysis
Conclusion: Compared with nonanticoagulation, anticoagulation therapy is associated with a reduced risk of death in older AF patients with nondialysis, but an increased risk of bleeding in older patients with dialysis.
Source: Medicine - October 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis 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

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

Statins do not improve cardiovascular outcomes for dialysis patients
Commentary on: Palmer SC, Navaneethan SD, Craig JC, et al.. HMG CoA reductase inhibitors (statins) for dialysis patients: a systematic review and meta-analysis. Cochrane Database Syst Rev 2013;(9):CD004289. Context Chronic kidney disease affected nearly 19 million people in the USA, with incidence increasing globally at an annual rate of 8%, most of which were unrecognised or undiagnosed. Cardiovascular events are common among patients with chronic kidney disease and highest in dialysis patients. While dialysis patients experience a high prevalence of traditional risk factors for cardiovascular disease (CVD), such as hyper...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Olyaei, A. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Neuromuscular disease, Stroke, Hypertension, Obesity (nutrition), Ischaemic heart disease, Unwanted effects / adverse reactions, Renal medicine, Musculoskeletal syndromes Source Type: research

Age may explain the association of an early dialysis initiation with poor survival
Conclusion: History of ischemic heart disease, serum albumin and dialysis start before 2005 were risk factors for mortality in ESRD patients. Older age is usually associated with early dialysis initiation, so age adjustment is needed to perform studies aimed to calculate the effect of eGFR at dialysis initiation on survival.
Source: QJM - October 24, 2014 Category: Internal Medicine Authors: Soler, M. J., Montero, N., Pascual, M. J., Barrios, C., Marquez, E., Orfila, M. A., Cao, H., Arcos, E., Collado, S., Comas, J., Pascual, J. Tags: Original papers Source Type: research

Primary prevention of cardiovascular disease events with renin-angiotensin system blockade in autosomal dominant polycystic kidney disease dialysis patients: A nationwide cohort study
Although renin-angiotensin system (RAS) blockade has been shown to reduce cardiovascular disease (CVD) in the general population and high-risk subjects, their protective effect in autosomal dominant polycystic kidney disease (ADPKD) patients under dialysis was still unknown. By using the database from 1995 to 2008 Taiwan National Health Insurance Research Database (Registry for Catastrophic Illnesses), we included 387 ADPKD patients who received dialysis therapy, aged ≥ 18 year-old, and with no evidence of CVD events in 1997 and 1998. We utilized Cox proportional hazards regression analysis and propensity score mat...
Source: Medicine - July 2, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research