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Warfarin use and the risks of stroke and bleeding in hemodialysis patients with atrial fibrillation: A systematic review and a meta-analysis
Conclusion This meta-analysis suggested that warfarin should not be recommended for the routine treatment of HD patients with AF.
Source: Nutrition, Metabolism and Cardiovascular Diseases - July 20, 2015 Category: Nutrition Source Type: research

Dose-Finding Study of Rivaroxaban in Hemodialysis Patients
Conclusions A 10-mg dose of rivaroxaban in hemodialysis patients without residual kidney function results in drug exposure similar as published for 20mg in healthy volunteers. Rivaroxaban is not eliminated by dialysis. There is no accumulation after multiple daily dosing. The efficacy and safety of rivaroxaban in hemodialysis patients should be the subject of a large randomized trial.
Source: American Journal of Kidney Diseases - June 22, 2015 Category: Urology & Nephrology Source Type: research

New aspects of cerebrovascular diseases in dialysis patients.
Authors: Naganuma T, Takemoto Y Abstract Growing evidence suggests that chronic kidney disease is a significant risk factor for stroke, subclinical cerebrovascular abnormalities, and cognitive impairment, independent of known cardiovascular risk factors. Cerebrovascular disease is also a major cause of death in dialysis patients, who have a much higher incidence of stroke compared to the normal population. Strokes in dialysis patients are also characterized by a higher incidence of hypertensive intracerebral hemorrhage compared with those in the general population. Recent studies on dialysis cohorts have shown that...
Source: Contributions to Nephrology - June 1, 2015 Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research

SuO001 * RISK OF ISCHAEMIC STROKE FOR INCIDENT PATIENTS TREATED WITH PERITONEAL DIALYSIS VERSUS HAEMODIALYSIS
Source: Nephrology Dialysis Transplantation - May 21, 2015 Category: Urology & Nephrology Authors: Stack, A. G., Elsayed, M. E., Sharif, M. U., Clarke Moloney, M., Ferguson, J. P. Tags: DIALYSIS CARDIOVASCULAR PATHOPHYSIOLOGY Source Type: research

Fp721 * rising global incidence of hemorrhagic stroke in hemodialysis
Source: Nephrology Dialysis Transplantation - May 21, 2015 Category: Urology & Nephrology Authors: Power, A., Usvyat, L., Marcelli, D., Canaud, B., Guinsburg, A., Marelli, C., Pusey, C., Levin, N., Kotanko, P., MONDO Initiative Tags: DIALYSIS. EPIDEMIOLOGY, OUTCOME RESEARCH, HEALTH SERVICES RESEARCH - 1 Source Type: research

Sp686 * contrasting worldwide trends of stroke incidence in hemodialysis - cause for concern
Source: Nephrology Dialysis Transplantation - May 21, 2015 Category: Urology & Nephrology Authors: Power, A., Usvyat, L., Pusey, C., Canaud, B., Marcelli, D., Guinsburg, A., Marelli, C., Levin, N., Kotanko, P., and the MONDO Initiative Tags: DIALYSIS. EPIDEMIOLOGY, OUTCOME RESEARCH, HEALTH SERVICES RESEARCH - 2 Source Type: research

Longer-term Outcomes of Darbepoetin Alfa Versus Epoetin Alfa in Patients With ESRD Initiating Hemodialysis: A Quasi-experimental Cohort Study
Conclusions In incident hemodialysis patients, mortality and cardiovascular event rates did not differ between patients treated at facilities predominantly using DPO versus EPO.
Source: American Journal of Kidney Diseases - May 2, 2015 Category: Urology & Nephrology Source Type: research

Dialysis
More than 400 000 persons in the United States are currently receiving maintenance dialysis as life-sustaining treatment for end-stage renal disease (ESRD), with more than 90% receiving in-center hemodialysis. Mortality rates in the ESRD population in the United States remain extremely high (18%-20% per year) despite a slight downward trend during the past 2 to 3 years. Most deaths among patients with ESRD are due to cardiovascular disease, with exceptionally high rates, particularly on an age-adjusted basis, of heart failure, stroke, and sudden death. In fact, sudden death accounts for roughly 1 in 4 deaths among patien...
Source: JAMA Internal Medicine - April 27, 2015 Category: Internal Medicine Source Type: research

Risk-based individualisation of target haemoglobin in haemodialysis patients with renal anaemia in the post-TREAT era: theoretical attitudes versus actual practice patterns (MONITOR-CKD5 study)
Conclusions Physicians’ theoretical attitudes to anaemia management in patients on haemodialysis appear to have been influenced by the results of the TREAT study, which involved patients not on dialysis. Physicians claim to use risk-based target Hb levels to guide renal anaemia care. However, there is discrepancy between these declared risk-based target Hb levels and actual target Hb levels for patients with variable risk factors.
Source: International Urology and Nephrology - April 17, 2015 Category: Urology & Nephrology Source Type: research

The Risks of Stroke and Bleeding for Warfarin Use in Hemodialysis Patients with Atrial Fibrillation: A Systemic Review and A Meta-Analysis
Conclusion This meta-analysis suggested that warfarin should not be recommended for the routine treatment of HD patients with AF.
Source: Nutrition, Metabolism and Cardiovascular Diseases - April 3, 2015 Category: Nutrition Source Type: research

Comparison of different interdialytic intervals among hemodialysis patients on their echocardiogram-based cardiovascular parameters
Conclusions In a selective Japanese outpatient population on maintenance HD, there were no differences in resting cardiovascular function measured by echocardiography at 3 different IDTs. However, exercise-induced afterload mismatch assessed by the changes in Ea, SV, SW, and SW/PVA efficiency was most pronounced in individuals after the long IDT compared with other IDTs. Our findings report potential pathophysiologic echocardiographic parameters that attempt to explain why cardiovascular events are highest on the day after the long IDT compared to other IDTs in dialysis patients.
Source: American Heart Journal - March 10, 2015 Category: Cardiology Source Type: research

Prevalence and correlates of functional dependence among maintenance dialysis patients
Abstract Functional dependence is an important determinant of longevity and quality of life. The purpose of the current study was to determine the prevalence and correlates of functional dependence among patients with end‐stage renal disease (ESRD) receiving maintenance dialysis. We enrolled 148 participants with ESRD from five clinics. Functional status, as measured by basic and instrumental activities of daily living (ADL, IADL), was ascertained by validated questionnaires. Functional dependence was defined as needing assistance in at least one of seven IADLs or at least one of four ADLs. Demographic characteristics, c...
Source: Hemodialysis International - March 2, 2015 Category: Hematology Authors: Niall T. Kavanagh, Brigitte Schiller, Anjali B. Saxena, I‐Chun Thomas, Manjula Kurella Tamura Tags: Original Article Source Type: research

Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Conclusions In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range.
Source: Nephrology Dialysis Transplantation - February 23, 2015 Category: Urology & Nephrology Authors: Genovesi, S., Rossi, E., Gallieni, M., Stella, A., Badiali, F., Conte, F., Pasquali, S., Bertoli, S., Ondei, P., Bonforte, G., Pozzi, C., Rebora, P., Valsecchi, M. G., Santoro, A. Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research

Comparison of Different Inter-dialytic Intervals Among Hemodialysis Patients on Their Echocardiogram-Based Cardiovascular Parameters
Conclusions In a selective Japanese outpatient population on maintenance hemodialysis, there were no differences in resting cardiovascular function measured by echocardiography at three different IDTs. However, exercise-induced afterload mismatch assessed by the changes in Ea, SV, SW and SW/PVA efficiency was most pronounced in individuals following the long IDT compared with other IDTs. Our findings report potential pathophysiologic echocardiographic parameters that attempt to explain why cardiovascular events are highest on the day after the long IDT compared to other IDTs in dialysis patients.
Source: American Heart Journal - February 13, 2015 Category: Cardiology Source Type: research

HDL Cholesterol, Apolipoproteins, and Cardiovascular Risk in Hemodialysis Patients
High concentrations of HDL cholesterol are considered to indicate efficient reverse cholesterol transport and to protect from atherosclerosis. However, HDL has been suggested to be dysfunctional in ESRD. Hence, our main objective was to investigate the effect of HDL cholesterol on outcomes in maintenance hemodialysis patients with diabetes. Moreover, we investigated the associations between the major protein components of HDL (apoA1, apoA2, and apoC3) and end points. We performed an exploratory, post hoc analysis with 1255 participants (677 men and 578 women) of the German Diabetes Dialysis study. The mean age was 66.3 yea...
Source: Journal of the American Society of Nephrology : JASN - January 30, 2015 Category: Urology & Nephrology Authors: Silbernagel, G., Genser, B., Drechsler, C., Scharnagl, H., Grammer, T. B., Stojakovic, T., Krane, V., Ritz, E., Wanner, C., Marz, W. Tags: Clinical Research Source Type: research

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