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anticoagulant hemodialysis

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https://www.readbyqxmd.com/read/29607945/atrial-fibrillation-had-less-impact-on-the-risk-of-ischemic-stroke-in-non-anticoagulated-patients-undergoing-hemodialysis-insight-from-the-rakuen-study
#1
Wataru Mitsuma, Taku Matsubara, Katsuharu Hatada, Shunsuke Imai, Makoto Tamura, Yutaka Tsubata, Kozo Ikarashi, Tetsuo Morioka, Noriko Saito, Hisaki Shimada, Shigeru Miyazaki
Objective The progress of non-anticoagulated patients with atrial fibrillation (AF) undergoing hemodialysis has not been determined. Using data from the RAKUEN (Registry of Atrial fibrillation in chronic Kidney disease Under hEmodialysis from Niigata) study, we examined the clinical characteristics and outcomes among hemodialysis patients with AF who were not receiving a vitamin K antagonist (VKA). Methods and Results Forty-three of 423 patients undergoing hemodialysis (-10%) were prescribed a VKA. The remaining 380 patients (age 64...
March 30, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29526376/clinical-effectiveness-of-open-thrombectomy-for-thrombosed-autogenous-arteriovenous-fistulas-and-grafts
#2
Amir A Ghaffarian, Ragheed Al-Dulaimi, Larry W Kraiss, Mark Sarfati, Claire L Griffin, Brigitte K Smith, Graham Donald, Benjamin S Brooke
OBJECTIVE: Arteriovenous (AV) fistulas are the preferred hemodialysis access for patients with end-stage renal disease, although multiple interventions are typically needed to maintain patency. When AV fistulas thrombose, however, there is debate as to whether open thrombectomy should be attempted, particularly for salvage of upper arm fistulas. This study was designed to evaluate outcomes after open thrombectomy of upper arm and forearm AV fistulas compared with AV grafts. METHODS: We identified all patients who underwent an open thrombectomy procedure for a thrombosed AV fistula or graft at a single academic medical center between January 2006 and March 2017...
March 8, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29509922/a-systematic-review-of-direct-oral-anticoagulant-use-in-chronic-kidney-disease-and-dialysis-patients-with-atrial-fibrillation
#3
Jordanne Feldberg, Param Patel, Ashley Farrell, Sylvia Sivarajahkumar, Karen Cameron, Jennifer Ma, Marisa Battistella
Background: There is a lack of clear benefit and a potential risk of bleeding with direct oral anticoagulant (DOAC) use in chronic kidney disease (CKD) and dialysis patients with atrial fibrillation. The objective of this study was to evaluate how treatment with DOACs affects stroke and bleeding outcomes compared with warfarin or aspirin. Methods: We conducted a systematic review of randomized controlled trials, cohort studies and case series, and searched electronic databases from 1946 to 2017...
March 2, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29426785/long-term-prognostic-impact-of-anticoagulation-on-patients-with-atrial-fibrillation-undergoing-hemodialysis
#4
Ruth María Sánchez Soriano, María Dolores Albero Molina, Carlos Israel Chamorro Fernández, Rocío Juliá-Sanchís, Ramón López Menchero, Carlos Del Pozo Fernández, Guillermo Grau Jornet, Julio Núñez Villota
INTRODUCTION AND OBJECTIVES: Evidence for the efficacy and safety of oral anticoagulation with dicumarines in patients with atrial fibrillation (AF) on hemodialysis is controversial. The aim of our study is to evaluate the long-term prognostic implications of anticoagulation with dicumarines in a cohort of patients with non-valvular AF on a hemodialysis program due to end-stage renal disease. METHODS: Retrospective, observational study with consecutive inclusion of 74 patients with AF on hemodialysis...
February 6, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29419934/evaluation-of-nafamostat-mesilate-as-an-alternative-anticoagulant-during-intermittent-hemodialysis-in-healthy-beagle-dogs
#5
Joon-Hyuk Choi, Seok-Yeong Byun, Aryung Nam, Sei-Myoung Han, Kyu-Pil Lee, Kun-Ho Song, Hwa-Young Youn, Kyoung-Won Seo
OBJECTIVE: To evaluate nafamostat mesilate (NM) as an alternative anticoagulant agent for intermittent hemodialysis (IHD). DESIGN: Prospective randomized study. SETTING: University teaching hospital. ANIMALS: Eighteen healthy Beagle dogs. INTERVENTIONS: In group 1 (n = 6), NM was administered at a dose of 0.5 mg/kg/h during IHD for 5 hours. In group 2 (n = 6), NM was administered at a low dose of 0...
February 8, 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29417731/super-high-flux-continuous-venovenous-hemodialysis-using-regional-citrate-anticoagulation-long-term-stability-of-middle-molecule-clearance
#6
Martin Siebeck, Thomas Dimski, Timo Brandenburger, Torsten Slowinski, Detlef Kindgen-Milles
Continuous renal replacement therapy is a standard treatment in critically ill patients with acute kidney injury. All CRRT techniques provide a high low-molecular weight clearance but even with hemofiltration, clearance of middle molecules is low. We investigated whether a new super high-flux hemofilter provides effective and sustained middle molecule clearance during citrate-anticoagulated continuous venovenous hemodialysis for up to 72 h. We included 14 critically ill patients with AKI-KDIGO-III in a prospective observational trial...
February 8, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29310600/warfarin-anticoagulation-in-hemodialysis-patients-with-atrial-fibrillation-comparison-of-nephrologist-led-and-anticoagulation-clinic-led-management
#7
Hamad Bahbahani, Ahmed AlTurki, Ahmed Dawas, Mark L Lipman
BACKGROUND: There is conflicting evidence of benefit versus harm for warfarin anticoagulation in hemodialysis patients with atrial fibrillation. This equipoise may be explained by suboptimal Time in Therapeutic Range (TTR), which correlates well with thromboembolic and bleeding complications. This study aimed to compare nephrologist-led management of warfarin therapy versus that led by specialized anticoagulation clinic. METHODS: In a retrospective cohort of chronic hemodialysis patients from two institutions (Institution A: Nephrologist-led warfarin management, Institution B: Anticoagulation clinic-led warfarin management), we identified patients with atrial fibrillation who were receiving warfarin for thromboembolic prophylaxis...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29259148/successful-recovery-from-spontaneous-spinal-epidural-hematoma-in-a-patient-undergoing-hemodialysis
#8
Arata Hibi, Takahisa Kasugai, Keisuke Kamiya, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
BACKGROUND Spontaneous spinal epidural hematoma (SSEH) occurs in the spinal epidural space in the absence of traumatic or iatrogenic causes, and is considered to be a neurological emergency, as spinal cord compression may lead to neurological deficit. Prompt diagnosis of SSEH can be difficult due to the variety of presenting symptoms, which may resemble those of stroke. Patients who undergo hemodialysis (HD) are at risk of bleeding due to anticoagulation during dialysis and uremia. However, SSEH in HD patients undergoing HD has rarely been reported...
December 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29171099/regional-citrate-anticoagulation-for-intermittent-hemodialysis-in-dogs
#9
T Francey, A Schweighauser
BACKGROUND: The traditional systemic heparinization used for anticoagulation in extracorporeal therapies may cause fatal complications in animals at risk of bleeding. HYPOTHESIS/OBJECTIVES: To develop and validate a protocol of regional citrate anticoagulation (RCA) for intermittent hemodialysis in dogs. ANIMALS: A total of 172 dogs treated with hemodialysis for acute kidney injury. METHODS: In vitro titration was performed, adding trisodium citrate and calcium chloride to heparinized canine blood...
January 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#10
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29092714/pylephlebitis-presenting-as-spontaneous-coronary-sinus-thrombosis-a-case-report
#11
Michael A Hart, Mengistu A Simegn
BACKGROUND: Coronary sinus thrombosis is a rare phenomenon. When identified, it most often is a complication of infective endocarditis or procedural intervention. We present an unusual and unreported case of spontaneous coronary sinus thrombosis as embolic sequela of an intra-abdominal infectious process. CASE PRESENTATION: We report a case of a 61-year-old white woman with a history of end-stage renal disease on hemodialysis, paroxysmal atrial fibrillation not on long-term systemic anticoagulation, and history of recurrent diverticulitis that presented with acute onset abdominal pain and nausea...
November 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29081491/deep-vein-thrombosis-complicated-by-spontaneous-iliopsoas-hematoma-in-patient-with-septic-shock
#12
Muhammad Umer Butt, Lili A Buzsaki, Susan S Smyth, Samy-Claude Elayi
BACKGROUND Spontaneous retroperitoneal hemorrhage (SRH) is a rare and difficult-to-diagnose entity. It is not associated with trauma, pathology, or iatrogenic manipulations. Few cases have been reported, with the only precipitating factor recognized being bleeding diatheses such as anticoagulation states, inherited coagulopathies, and hemodialysis. However, none of these have been described in combination with septic shock, which itself is associated with platelet dysfunction, coagulation dysfunction, and vasculopathy...
October 30, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29064182/anti-thrombotic-therapy-for-atrial-fibrillation-in-patients-with-chronic-kidney-disease-current-views
#13
REVIEW
Rugheed Ghadban, Greg Flaker, Natraj Katta, Martin A Alpert
Chronic kidney disease (CKD) occurs in approximately one-third of patients with non-valvular atrial fibrillation (AF). The presence of CKD, particularly advanced CKD, confers increased risk of both thromboembolism and major bleeding in this group of patients who are already at risk for ischemic stroke and systemic embolism and at risk of bleeding due to anticoagulation. Studies assessing the effect of warfarin on risk of ischemic stroke, systemic embolism, and major bleeding have produced disparate results, particularly in patients with advanced CKD including those treated with hemodialysis...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29045980/-anti-neutrophil-cytoplasmic-antibodies-associated-vasculitis-with-lung-hemorrhage-in-the-patient-on-maintenance-haemodialysis-a-case-report
#14
J X Ding, M Wang
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is usually a multisystem disorder, and pulmonary renal syndrome is a common presentation. Patients with AAV are less likely to experience relapse when they progress to end-stage renal disease (ESRD). We report a rare case of diffuse alveolar hemorrhage (DAH) in relapsing AAV after eight years of haemodialysis. A 58-year-old woman was admitted to our hospital with the chief complaints of dyspnea and hemoptysis accompanied by anemia, fever, fatigue, and weight loss...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29026846/intracranial-hemorrhage-in-methanol-toxicity-challenging-the-probable-heparin-effect-during-hemodialysis
#15
Hossein Hassanian-Moghaddam, Hooman Bahrami-Motlagh, Nasim Zamani, Seyed Amirhossein Fazeli, Behdad Behnam
Brain hemorrhages are rare complications of acute methanol poisoning. There is a debate on association of brain hemorrhage in methanol toxicity and application of systemic anticoagulation during hemodialysis (HD). A 70-year-old male presented to us with severe metabolic acidosis and a methanol level of 7.6 mg/dL. Ethanol and folinic acid were administered, and HD was performed. Brain computed tomography (CT) scan which was normal on presentation showed extensive bilateral subcortical supratentorial hypodensities on the 3rd day after commencing the treatment...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28894790/aortic-dissection-and-severe-renal-failure-6-years-after-kidney-transplantation
#16
Amaury Dujardin, Awena Le Fur, Diego Cantarovich
We report the case of a patient with long-term history of hypertension, presenting with transient neurological disorders and severe graft failure several years after kidney transplantation. Cause of end-stage renal disease was hypertensive nephrosclerosis. Chronic hemodialysis lasted for 1 year. After transplantation and throughout follow-up, serum creatinine ranged from 200 to 230 μmol/L and maintenance immunosuppression included sirolimus and low-dose steroids. Six years after transplantation, the patient presented with right hip pain radiating to the lower back, transient aphasia, confusion, and hemiparesis...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#17
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
December 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#18
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28836163/blood-glutamate-reducing-effect-of-hemofiltration-in-critically-ill-patients
#19
Evgeni Brotfain, Ruslan Kutz, Julia Grinshpun, Benjamin F Gruenbaum, Shaun E Gruenbaum, Amit Frenkel, Agzam Zhumadilov, Vladimir Zeldetz, Yoav Bichovsky, Matthew Boyko, Moti Klein, Alexander Zlotnik
Glutamate toxicity plays a well-established role in secondary brain damage following acute and chronic brain insults. Previous studies have demonstrated the efficacy of hemodialysis and peritoneal dialysis in reducing blood glutamate levels. However, these methods are not viable options for hemodynamically unstable patients. Given more favorable hemodynamics, longer treatment, and less needed anticoagulation, we investigated whether hemofiltration could be effective in lowering blood glutamate levels. Blood samples were taken from 10 critically ill patients immediately before initiation of hemofiltration and after 1, 2, 4, 6, and 12 h, for a total of 6 blood samples...
February 2018: Neurotoxicity Research
https://www.readbyqxmd.com/read/28802549/diffuse-renal-cortical-hemorrhage-in-the-setting-of-subcapsular-hematoma-diagnosis-and-treatment-with-embolization
#20
Marta Burrel, Marta Barrufet, Maria Carme Sebastia, Jonathan Joudanin, Laura Buñesch, Patricia Bermudez, Jordi Blasco, Rosa Gilabert
PURPOSE: To describe radiologic findings, embolization technique, and clinical outcomes in patients with renal subcapsular hematoma and diffuse cortical hemorrhage. MATERIALS AND METHODS: Ten patients with renal subcapsular hematoma and diffuse cortical hemorrhage were reviewed. Nine of the 10 had undergone procedures (nephrostomy, n = 4; biopsy, n = 4; embolization of a cerebral aneurysm, n = 1) and 1 patient was receiving oral anticoagulation. Computed tomography (CT), angiography, and embolization of bleeding sites were performed in all patients...
November 2017: Journal of Vascular and Interventional Radiology: JVIR
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