Safety Outcomes of Apixaban Compared With Warfarin in Patients With End-Stage Renal Disease

2017 ◽  
Vol 51 (6) ◽  
pp. 445-450 ◽  
Author(s):  
Stefanie C. Sarratt ◽  
Ross Nesbit ◽  
Robert Moye
Keyword(s):  
Renal Disease ◽  
Major Bleeding ◽  
End Stage Renal Disease ◽  
Chronic Hemodialysis ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Warfarin Group ◽  
Major Bleeding Events ◽  
Stage Renal Disease ◽  
End Stage

Background: Current guidelines make no specific recommendations on the selection of direct oral anticoagulants for the prevention and treatment of venous thromboembolism in patients with end-stage renal disease (ESRD) receiving hemodialysis. Based on these guidelines, warfarin remains the anticoagulant of choice in these patients. Objective: To compare bleeding rates in patients receiving apixaban or warfarin with ESRD undergoing chronic hemodialysis. Methods: This was a single-center, retrospective, institutional review board–approved cohort analysis. Patients with ESRD undergoing chronic hemodialysis and receiving anticoagulation therapy with either apixaban or warfarin were included in this study. All data were collected from paper charts and electronic medical records and included documentation of bleeding events and related interventions. The primary outcome of this study was clinically relevant major bleeding events. Secondary outcomes included clinically relevant nonmajor bleeding events and minor bleeding events. Results: A total of 160 patients were included in this study (warfarin group, n = 120; apixaban group, n = 40). There were 7 major bleeding events in the warfarin group compared with zero in the apixaban group ( P = 0.34). There were similar rates of clinically relevant nonmajor bleeding events (12.5% vs 5.8%, P = 0.17) and minor bleeding (2.5% vs 2.5%, P = 0.74) events in patients receiving apixaban and warfarin. Conclusions: There were no observed differences in bleeding rates in patients receiving apixaban compared with those receiving warfarin. Apixaban may be a cautious consideration in hemodialysis patients until there is further insight into the effect of subsequent, multiple doses on drug accumulation and clinical outcomes.

Relationship Between Volume Status and Blood Pressure in Children with End Stage Renal Disease on Chronic Hemodialysis

2007 ◽  
Vol 7 (2) ◽  
pp. 210-215
Author(s):  
Fatina I. Fadel ◽  
Samar M. Sabry ◽  
Azza M.O. Abdel Rahm ◽  
Emad Eldin E. Salama ◽  
Marwa M. El-Sonbaty
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Chronic Hemodialysis ◽  
Volume Status ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Phase IIa Study of the Immunogenicity and Safety of the Novel Staphylococcus aureus Vaccine V710 in Adults with End-Stage Renal Disease Receiving Hemodialysis

2012 ◽  
Vol 19 (9) ◽  
pp. 1509-1516 ◽  
Author(s):  
Moustafa Moustafa ◽  
George R. Aronoff ◽  
Chandra Chandran ◽  
Jonathan S. Hartzel ◽  
Steven S. Smugar ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Geometric Mean ◽  
Surface Protein ◽  
Chronic Hemodialysis ◽  
Content Type ◽  
Primary Hypothesis ◽  
Stage Renal Disease ◽  
End Stage

ABSTRACTBacteremia is the second leading cause of death in patients with end-stage renal disease who are on hemodialysis. A vaccine eliciting long-term immune responses againstStaphylococcus aureusin patients on chronic hemodialysis may reduce the incidence of bacteremia and its complications in these patients. V710 is a vaccine containing iron surface determinant B (IsdB), a highly conservedS. aureussurface protein, which has been shown to be immunogenic in healthy subjects. In this blinded phase II immunogenicity study, 206 chronic hemodialysis patients between the ages of 18 and 80 years old were randomized to receive 60 μg V710 (with or without adjuvant), 90 μg V710 (with adjuvant), or a placebo in various combinations on days 1, 28, and 180. All 201 vaccinated patients were to be followed through day 360. The primary hypothesis was that at least 1 of the 3 groups receiving 2 V710 doses on days 1 and 28 would have a ≥2.5 geometric mean fold rise (GMFR) in anti-IsdB IgG titers over the baseline 28 days after the second vaccination (day 56). At day 56, all three groups receiving 2 doses of V710 achieved a ≥2.5 GMFR in anti-IsdB antibodies compared to the baseline (Pvalues of <0.001 for all 3 groups), satisfying the primary immunogenicity hypothesis. None of the 33 reported serious adverse experiences were considered vaccine related by the investigators. V710 induced sustained antibody responses for at least 1 year postvaccination in patients on chronic hemodialysis.

Utilization of Peritoneal Dialysis in the Acute Setting

2007 ◽  
Vol 27 (3) ◽  
pp. 328-331 ◽  
Author(s):  
Daniela Ponce Gabriel ◽  
Juan Fernández-Cean ◽  
André Luis Balbi
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
High Volume ◽  
Infectious Complications ◽  
Chronic Hemodialysis ◽  
Attractive Alternative ◽  
Acute Setting ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis (PD), although classically described and utilized in the treatment of patients with end-stage renal disease, can also be utilized in the acute setting in different clinical situations. Recent studies showed that, in patients with acute renal failure, it is possible to obtain reasonable dialysis doses with adequate metabolic and electrolytic control and low incidence of complications by utilizing continuous PD through a cycler at high volume. In patients with congestive heart failure without end-stage renal disease, PD is capable of promoting clinical improvement with slow removal of liquids, becoming an attractive alternative for situations of rapidly or slowly worsening cardiac function. In patients submitted to chronic hemodialysis but who have vascular access difficulties, PD can also be utilized as a “bridge,” thereby avoiding the use of central venous catheters, which can be associated with infectious complications such as bacterial endocarditis. New studies must be realized showing other indications for PD.

scholarly journals Echocardiographic Assessment of Cardiac Structural and Functional Abnormalities in Patients With End-Stage Renal Disease Receiving Chronic Hemodialysis

2018 ◽  
Vol 82 (2) ◽  
pp. 586-595 ◽  
Author(s):  
Hiroshi Matsuo ◽  
Kaoru Dohi ◽  
Hirofumi Machida ◽  
Hideyuki Takeuchi ◽  
Toshikazu Aoki ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Chronic Hemodialysis ◽  
Echocardiographic Assessment ◽  
Stage Renal Disease ◽  
End Stage
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