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anticoagulant hemodialysis

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https://www.readbyqxmd.com/read/29898003/influence-of-citrate-concentration-on-the-activation-of-blood-cells-in-an-in-vitro-dialysis-setup
#1
Jakob Gubensek, Karin Strobl, Stephan Harm, Rene Weiss, Tanja Eichhorn, Jadranka Buturovic-Ponikvar, Viktoria Weber, Jens Hartmann
BACKGROUND: Regional citrate anticoagulation has been associated with enhanced biocompatibility in hemodialysis, but the optimal dose of citrate remains to be established. Here, we compared parameters related to cellular activation during in vitro dialysis, using two doses of citrate. METHODS: Human whole blood, anticoagulated with either 3 mM or 4 mM of citrate, was recirculated in an in vitro miniaturized dialysis setup. Complement (C3a-desArg), soluble platelet factor 4 (PF4), thromboxane B2 (TXB2), myeloperoxidase (MPO), as well as platelet- and red blood cell-derived extracellular vesicles (EV) were quantified during recirculation...
2018: PloS One
https://www.readbyqxmd.com/read/29886476/albumin-loss-and-citrate-load-in-pre-dilution-high-cut-off-cvvhdf-with-regional-citrate-18-mmol-l-and-high-cut-off-cvvhd-with-systemic-heparin-an-in-vitro-study
#2
Gianluca Villa, Mauro Neri, Silvia De Rosa, Sara Samoni, Cosimo Chelazzi, Stefano Romagnoli, Anna Lorenzin, Massimo de Cal, Claudio Ronco, Angelo Raffaele De Gaudio
BACKGROUND: Convective therapies with high cut-off membranes (HCO) are usually not recommended because of theoretical excessive albumin loss. The aim of this in vitro study is to demonstrate the noninferior safety of pre-dilution hemodiafiltration with HCO (HCO-CVVHDF) with isotonic citrate anticoagulation (18 mmol/L) with respect to heparin anticoagulated hemodialysis with HCO (HCO-CVVHD) in terms of albumin removal and citrate load. METHOD: -Albumin removal was compared in vitro between 3 pre--dilution-HCO-CVVHDF with citrate anticoagulation and 3 -HCO-CVVHD with heparin anticoagulation during 30-min single-pass and 180-min recirculation phases...
June 8, 2018: Blood Purification
https://www.readbyqxmd.com/read/29859647/use-of-regional-citrate-anticoagulation-for-continuous-venovenous-hemodialysis-in-critically-ill-cancer-patients-with-acute-kidney-injury
#3
Verônica Torres Costa E Silva, Renato Antunes Caires, Juliana Silva Bezerra, Elerson C Costalonga, Ana Paula Leandro Oliveira, Fernanda de Oliveira Coelho, Julia T Fukushima, Cilene Muniz Soares, Luciane Oikawa, Ludhmila Abrahão Hajjar, Emmanuel A Burdmann
PURPOSE: This study aimed to evaluate the safety and efficacy of a regional citrate anticoagulation (RCA) protocol for continuous venovenous hemodialysis (CVVHD) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) setting. MATERIAL AND METHODS: One hundred twenty two consecutive ICU cancer patients with AKI treated with citrate-based CVVHD were prospectively evaluated in this prospective observational study. RESULTS: A total of 7198 h of CVVHD therapy (250 filters) were performed...
April 6, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29846888/safety-analysis-of-apixaban-versus-warfarin-in-patients-with-advanced-kidney-disease
#4
Michael Bowie, Violet Valencia, Ingrid Perez-Alvarez, Minh-Ha Tran
Anticoagulation in patients with advanced kidney disease, defined as those with an eGFR < 25 mL/min, including patients with end-stage renal disease on hemodialysis, remains an area of controversy and debate. Due to safety concerns regarding the increased risk for bleeding in this population, these patients have been excluded from all large-scale, randomized controlled trials to date. Warfarin and apixaban are both FDA-approved for use in this population and although warfarin remains the anticoagulant of choice, apixaban use is steadily increasing...
May 30, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29806324/-clinical-application-of-ultrasound-guided-fogarty-balloon-catheter-in-arterial-crisis
#5
Xiaodong Li, Pei Wang, Changyu Yu, Xiaowei Yan, Jing Yin
Objective: To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter. Methods: Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). The limb mutilation position was at knee joint in 3 cases, lower limb in 9 cases, ankle joint in 6 cases, elbow joint in 2 cases, forearm in 4 cases, and wrist joint in 3 cases...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29804743/management-of-tunneled-cuffed-catheter-related-right-atrial-thrombosis-in-hemodialysis-patients
#6
Hongliu Yang, Feng Chen, He Jiao, Han Luo, Yang Yu, Hyokyoung G Hong, Yi Li, Ping Fu, Tianlei Cui
OBJECTIVES: Catheter-related right atrial thrombosis (CRAT) is an underreported but potentially life-threatening complication associated with the use of tunneled-cuffed catheters among hemodialysis (HD) patients. Because little is known about the evidence-based guidelines for the optimal management of CRAT among HD patients, this article reports findings based on 20 patients diagnosed with CRAT after catheter replacement and anticoagulation treatment. METHODS: The article retrospectively reviews the hospital records of 20 HD patients treated in the West China Hospital with diagnosis of CRAT from March 2013 to May 2016...
May 24, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29783247/predictors-of-thrombogenesis-by-the-state-of-pro-and-anticoagulant-components-of-hemostasis-in-the-patients-with-stage-vd-chronic-kidney-disease
#7
Olexiy B Storozhuk, Iryna B Seleznyova, Larisa O Storozhuk, Boris G Storozhuk, Tetyana V Dovgalyuk
OBJECTIVE: Introduction: One of the major complications of stage V chronic kidney disease (CKD), treated by program hemodialysis, are hemostatic system disturbances resulting in thrombosis development. To detect early predictors of potential thrombosis in study category of patients is rather difficult because of inflammatory process, accumulation of antibodies, continuous damage of blood elements. The aim: To estimate potential applicability of activators and inhibitors of thrombogenesis as thrombophilia markers in the patients with stage V CKD, treated by program hemodialysis...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782263/-nonvalvular-atrial-fibrillation-and-diabetic-nephropathy-epidemiology-prognosis-and-choice-of-anticoagulant-therapy
#8
N A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29775967/bilateral-breast-calciphylaxis-in-a-patient-who-survived-earlier-extensive-tissue-necrosis-5-years-previously-a-case-report
#9
E M J Verstappen, A J G Maaskant-Braat, M R Scheltinga
INTRODUCTION: Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis. PRESENTATION OF CASE: A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29756014/hemodialysis-is-a-strong-risk-factor-for-post-endoscopic-sphincterotomy-bleeding-in-patients-with-choledocholithiasis
#10
So Nakaji, Nobuto Hirata, Hiroki Matsui, Toshiyasu Shiratori, Masayoshi Kobayashi, Shigenobu Yoshimura, Keisuke Kanda, Natsuki Kawamitsu, Hisato Harasawa
Background and study aims:  Hemodialysis (HD) is considered one of the risk factors for post-endoscopic sphincterotomy (ES) bleeding. Therefore, we conducted a retrospective study to evaluate HD as a risk factor for post-ES bleeding in patients with choledocholithiasis. Patients and methods:  We used the post-ES bleeding rate as the main outcome measure. To evaluate the influence of HD on the risk of post-ES bleeding, logistic regression and propensity score analyses were conducted...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29749281/is-the-removal-of-a-central-venous-catheter-always-necessary-in-the-context-of-catheter-related-right-atrial-thrombosis
#11
Luigi Rossi, Pasquale Libutti, Francesco Casucci, Piero Lisi, Annalisa Teutonico, Carlo Basile, Carlo Lomonte
Catheter-related right atrial thrombosis is a severe and life-threatening complication of central venous catheters in both adult and young patients. Catheter-related right atrial thrombosis can occur with any type of central venous catheters, utilized either for hemodialysis or infusion. Up to 30% of patients with central venous catheter are estimated to be affected by catheter-related right atrial thrombosis; however, neither precise epidemiological data nor guidelines regarding medical or surgical treatment are available...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29745004/heparin-free-renal-replacement-therapy-for-chronic-hemodialyzed-patients-at-high-risk-for-bleeding-a-comparison-of-on-line-predilution-hemodiafiltration-with-conventional-hemodialysis
#12
Vincent Brunot, Jean-Emmanuel Serre, Georges Mourad, Kada Klouche, Vincent Pernin
BACKGROUND: In chronic hemodialysis patients with high risk of bleeding, optimal anticoagulation of the extracorporeal circuit is challenging. Heparin-free hemodialysis (HD) with heparin-coated AN69ST dialyzer is now considered as a good option and recommended by experts. Predilutional hemodiafiltration (HDF) may represent also a feasible alternative but has been poorly investigated. In this study, our aim was to evaluate the performance of on-line automated predilution heparin-free HDF as compared to conventional heparin-free HD with a heparin-coated membrane...
May 10, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29744595/synthesis-and-biocompatibility-of-an-argatroban-modified-polysulfone-membrane-that-directly-inhibits-thrombosis
#13
Xiao Fu, Jian-Ping Ning
Anticoagulation therapy plays a vital role in the prevention of blood clot formation during hemodialysis and hemofiltration, especially for critical care patients. Here, we synthesized a novel argatroban (Arg)-modified polysulfone (PSf) membrane for anticoagulation. Arg was grafted onto the PSF membrane via chemical modification to increase membrane hydrophilicity. Protein adsorption, coagulation, as well as activation of platelets and complement systems were greatly reduced on the Arg-modified PSf membrane...
May 9, 2018: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/29722112/the-development-of-central-venous-thrombosis-in-hemodialyzed-patients-is-associated-with-catheter-tip-depth-and-localization
#14
Vedran Premuzic, Drazen Perkov, Ranko Smiljanic
INTRODUCTION: The aim of our work was to analyze the incidence of tunneled hemodialysis catheters-related thrombosis in hemodialyzed patients depending on catheter tip depth and position and to evaluate the impact of other established risk factors responsible for development of central venous thrombosis. METHODS: The presence of central vein thrombosis, location, and the depth of the catheter tip was reviewed by two experienced radiologists. All patients with suspected central venous thrombosis had factor V Leiden, lupus anticoagulant, and cardiolipin antibodies checked (acIgM and acIgG) and were evaluated with cat-scan venography...
May 2, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29682371/colonic-mucosal-ulceration-and-gastrointestinal-bleeding-associated-with-sevelamer-crystal-deposition-in-a-patient-with-end-stage-renal-disease
#15
Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia...
2018: Case Reports in Nephrology
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
#16
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
#17
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
#18
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
#19
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
#20
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...
March 2018: Journal of Veterinary Emergency and Critical Care
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