scholarly journals Oral Anticoagulant Therapy in Patients Receiving Haemodialysis: Is It Time to Abandon It?

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Marek Saracyn ◽  
Dorota Brodowska-Kania ◽  
Stanisław Niemczyk
Keyword(s):  
Atrial Fibrillation ◽  
Renal Failure ◽  
Venous Thromboembolism ◽  
End Stage Renal Disease ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
End Stage Renal Failure ◽  
The Moment ◽  
Stage Renal Disease ◽  
End Stage

Oral anticoagulant (OAC) therapy in haemodialysis patients causes a great deal of controversy. This is because a number of pro- and anticoagulant factors play an important role in end-stage renal failure due to the nature of the disease itself. In these conditions, the pharmacokinetic and pharmacodynamic properties of the OACs used change as well. In the case of the treatment of venous thromboembolism, the only remaining option is OAC treatment according to regimens used for the general population. Prevention of HD vascular access thrombosis with the use of OACs is not very effective and can be dangerous. However, OAC treatment in patients with atrial fibrillation in dialysis population may be associated with an increase in the incidence of stroke and mortality. Doubts should be dispelled by prospective, randomised studies; at the moment, there is no justification for routine use of OACs in the above-mentioned indications. In selected cases of OAC therapy in this group of patients, it is absolutely necessary to control and monitor the applied treatment thoroughly. Indications for the use of OACs in patients with end-stage renal disease, including haemodialysis patients, should be currently limited.

scholarly journals Conjugated estrogen is an effective option to manage chronic GI bleeding in a patient with atrial fibrillation and end-stage renal disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Matthew T Compton ◽  
Krupa Patel
Keyword(s):  
Atrial Fibrillation ◽  
Renal Failure ◽  
End Stage Renal Disease ◽  
Clinical Decision ◽  
Gi Bleeding ◽  
Conjugated Estrogens ◽  
Effective Option ◽  
Stage Renal Disease ◽  
End Stage ◽  
Conjugated Estrogen

A clinical decision report appraising: Livio M, Mannucci PM, Viganò G, Mingardi G, Lombardi R, Mecca G, Remuzzi G. Conjugated estrogens for the management of bleeding associated with renal failure. N Engl J Med. 1986;315:731-735 https://doi.org/10.1056/NEJM198609183151204 for a patient with chronic GI bleeding and complicated pro- and anti-coagulation needs.

Issues Related to the Care of Critically Ill Patients with End Stage Renal Failure

1992 ◽  
Vol 3 (3) ◽  
pp. 585-596
Author(s):  
Christy A. Price
Keyword(s):  
Renal Failure ◽  
Intensive Care ◽  
Critically Ill ◽  
End Stage Renal Disease ◽  
Treatment Options ◽  
Nursing Interventions ◽  
End Stage Renal Failure ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End stage renal disease (ESRD) affects every aspect of an individual’s lifestyle. Pharmacologic, dietary, and treatment options and other organ involvement become daily realities for ESRD patients. When ESRD patients are admitted to intensive care units, these realities become concerns for the nurses. This article addresses the considerations that must be included in the nursing interventions for the critically ill ESRD patients

The Effect of Somatostatin on the Hormonal Abnormalities of End Stage Renal Disease

1981 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Thomas G Murray ◽  
Carol Eisen ◽  
Morris Grabie ◽  
Ellen Buerklin ◽  
Barry R Walker ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Control Period ◽  
Thyroid Stimulating Hormone ◽  
Dialysis Patients ◽  
End Stage Renal Failure ◽  
Stage Renal Disease ◽  
End Stage

Patients with end stage renal disease who are maintained on haemodialysis have elevated levels of many hormones, some of which may play a role in the pathogenesis of the complications of uraemia. The infusion of synthetic somatostatin reduces the circulating level of many of these same hormones in patients with normal renal function. If the elevated hormone levels in dialysis patients could be similarly lowered, study of the pathogenitic significance of the various hormonal abnormalities would be facilitated. With this in mind, the effect of synthetic somatostatin on the circulating level of growth hormone, glucagon, insulin, gastrin, parathyroid hormone, and thyroid stimulating hormone in dialysis patients was investigated. In pilot protocol, a dose of 2 mg of somatostatin infused over 24, 18, or 12 hours (two patients each) was found to have no effect on any hormonal level. Infusion of 2 mg of somatostatin over 4 hours, however, was associated with consistent fall in the level of growth hormone (13.6 ± 6.2 to 6.53 ± 2.9, p = 0.15) and glucagon (595.0 ± 73 to 441 ± 28, p < 0.05) in each of four patients. The percentage change in the level of growth hormone and glucagon during the 4-hour somatostatin infusion was significantly different from the change occurring during a 4-hour timed control period (growth hormone —45 ± 18% vs +9 ± 7%, [p < 0.05]), (glucagon −27% ± 2% vs + 8 ± 2%, [p < 0.01]). There was no change in the level of any other hormone during the 4-hour infusion. No significant adverse effects were seen. This study suggests that the intravenous infusion of somatostatin can, at least on an acute basis, lower the level of growth hormone and glucagon in patients with end stage renal failure; and, therefore, it may be useful in further study and possibly the treatment of the hormonal abnormalities of end stage renal disease.

scholarly journals Penile calciphylaxis: a conservative approach

2020 ◽  
Vol 102 (2) ◽  
pp. e36-e38 ◽  
Author(s):  
O El-Taji ◽  
J Bondad ◽  
S Faruqui ◽  
J Bycroft
Keyword(s):  
Renal Failure ◽  
End Stage Renal Disease ◽  
Multidisciplinary Approach ◽  
Renal Dialysis ◽  
Conservative Approach ◽  
End Stage Renal Failure ◽  
Calcific Uremic Arteriolopathy ◽  
Individual Entity ◽  
Stage Renal Disease ◽  
End Stage

Penile calciphylaxis or calcific uremic arteriolopathy is a rare urological condition often associated with patients undergoing renal dialysis for end-stage renal disease. The majority of cases are associated with systemic calciphylaxis. The pathophysiology, diagnosis and management of penile calciphylaxis as an individual entity has brought little attention. The rates of comorbidity and mortality of these patients are often particularly high. Early diagnosis and a multidisciplinary approach are therefore essential. We report a case of penile calciphylaxis in a 59-year-old man with end-stage renal failure on haemodialysis who was successfully managed conservatively.

scholarly journals Direct Oral Anticoagulants in End-Stage Renal Disease

2018 ◽  
Vol 44 (04) ◽  
pp. 353-363 ◽  
Author(s):  
Vicky Tagalakis ◽  
Adi Klil-Drori
Keyword(s):  
Atrial Fibrillation ◽  
Venous Thromboembolism ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
The United States ◽  
Current Evidence ◽  
Stage Renal Disease ◽  
End Stage

AbstractPatients with end-stage renal disease (ESRD) were excluded from pivotal clinical trials with oral anticoagulants. While such patients are at an increased risk of venous and arterial thromboembolism, their risk of bleeding is also elevated. It is thus of little surprise that stroke prevention with vitamin K antagonists (VKAs) in ESRD patients with atrial fibrillation is controversial, with observational evidence ranging from beneficial to harmful. This uncertainty extends to the less studied use of VKAs for venous thromboembolism in ESRD. The direct oral anticoagulants (DOACs) apixaban and rivaroxaban have now permissive labeling in the United States for atrial fibrillation in patients with ESRD; this expanded labeling has not yet occurred either in Europe or for venous thromboembolism. This review summarizes the current evidence for the pharmacology of DOACs in ESRD as well as their utilization and safety in patients with ESRD and atrial fibrillation.

scholarly journals HARAPAN PADA PENYAKIT GINJAL KRONIS TAHAP AKHIR (PGKTA) : SYSTEMATIC REVIEW

2019 ◽  
Vol 2 (2) ◽  
pp. 41
Author(s):  
Nining Puji Astuti
Keyword(s):  
Systematic Review ◽  
Renal Failure ◽  
Renal Disease ◽  
Full Text ◽  
End Stage Renal Disease ◽  
End Stage Renal Failure ◽  
Herth Hope Index ◽  
Trait Hope ◽  
Stage Renal Disease ◽  
End Stage

Latar belakang:. Harapan merupakan faktor prediktor independen yang berhubungan langsung dengan kualitas hidup PGKTA. Harapan memiliki peran penting untuk meningkatkan motivasi, koping, kemauan menjalani pengobatan dan outcome positif PGKTA.Tujuan: Tujuan dari sistematic review ini adalah untuk mengidentifikasi konsep harapan berdasarkan definisi dan instrumen yang dapat digunakan untuk mengukur harapan PGKTA, mengidentifikasi faktor yang mempengaruhi harapan PGKTA.Metode: Metode pencarian melalui PUBMED dan Google Schoolar dengan kata kunci “hope, End Stage Renal Disease, End Stage Renal Failure, Hemodialysis”. Hanya jurnal dalam Bahasa Inggris, full text, dipublikasikan tahun 2000-2019 dan menggunakan harapan sebagai tema utama dalam pembahasan yang digunakan dalam pembuatan sistematik review ini.Hasil : Harapan di definisikan sebagai kekuatan dalam diri individu yang membantu pasien keluar dari zona sakitnya dan meningkatkan derajat kesehatannya. Alat ukur yang dapat dipakai antara lain Herth Hope Index, The Trait Hope Scale, Adult Hope Scale, Miller Hope Scale, Basic Hope Inventory.Kesimpulan: Perlu kajian lebih dalam mengenai faktor dominan yang mempengaruhi harapan untuk membantu penentuan asuhan keperawatan yang tepat terkait harapan.

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