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Vitamin K hemodialysis

Maria Fusaro, Maurizio Gallieni, Andrea Aghi, Maria Antonietta Rizzo, Giorgio Iervasi, Thomas L Nickolas, Fabrizio Fabris, Maria Cristina Mereu, Sandro Giannini, Stefania Sella, Andrea Giusti, Annalisa Pitino, Graziella D'Arrigo, Maurizio Rossini, Davide Gatti, Maura Ravera, Luca Di Lullo, Antonio Bellasi, Giuliano Brunori, Antonio Piccoli, Giovanni Tripepi, Mario Plebani
BACKGROUND AND AIMS: Diabetes mellitus is recognized as one of the major causes of end stage kidney disease. Bone Gla protein (BGP) is a vitamin K-dependent protein involved in bone mineralization and vascular calcifications (VC). Our goal was to characterize BGP and undercarboxylated BGP (ucBGP) in DM patients on HD, compared to HD patients without DM, and their association with vascular and bone disease. METHODS: 387 HD patients from 18 dialysis centers in Italy...
February 13, 2019: Journal of Nephrology
Medine Alpdemir, Mehmet Eryilmaz, Mehmet Fatih Alpdemir, Güler Topçu, Alper Azak, Doğan Yücel
Background: The aim of this study is to determine whether the saliva analysis is an alternative to routine biochemical and immunoassay analyses in patients undergoing perito - neal dialysis (PD) or hemodialysis (HD). Methods: Study group consisted of 40 healthy control, 44 PD and 44 HD patients. Routine biochemical analytes, thyroid stimulating hormone (TSH), free T3, free T4, vitamin B12, ferritin and folic acid were measured. Results: Compared to pre-HD, urea, creatinine, uric acid, potassium levels were lower in post-HD, and calcium, magnesium, vitamin B12 levels were higher in post-HD both in saliva and serum...
July 2018: Journal of Medical Biochemistry
Rasheeda K Hall, Julia J Scialla
No abstract text is available yet for this article.
December 11, 2018: JAMA: the Journal of the American Medical Association
Paweł Balsam, Monika Gawałko, Michał Peller, Agata Tymińska, Krzysztof Ozierański, Martyna Zaleska, Katarzyna Żukowska, Katarzyna Szepietowska, Kacper Maciejewski, Marcin Grabowski, Mariusz Borkowski, Łukasz Kołtowski, Anna Praska-Oginska, Inna Zaboyska, Grzegorz Opolski, Janusz Bednarski
Congestive heart failure (CHF) and atrial fibrillation (AF) frequently coexist and are associated with increased risk of cardiovascular events.To compare baseline characteristics, comorbidities and pharmacotherapy in AF patients with concomitant CHF to those without CHF.The study included 3506 real-life AF patients with (37.1%) and without CHF - participants of the multicentre, retrospective MultiCenter expeRience in AFib patients Treated with OAC (CRAFT) trial (NCT02987062).All patients were treated with non-vitamin K antagonist oral anticoagulants (NOAC) or vitamin K antagonists (VKA)...
November 2018: Medicine (Baltimore)
Mariam Chettati, Adil Adnouni, Wafae Fadili, Inass Laouad
Calcific uremic arteriolopathy, also called calciphylaxis, is a rare and severe disorder that presents with skin ischemia and necrosis, sometimes it presents with systemic necrosis, the process is secondary to the obliteration of the arterioles first by sub-intimal calcium deposits and then by thrombosis. These lesions can often lead to death due to infectious complications and comorbidities such as diabetes, obesity, arteritis, diffuse vascular calcifications, heart disease and undernutrition. The diagnosis is suggested by the characteristic ischemic skin lesions and their distribution, often bilateral and painful, associeted with calcific uremic arteriolopathy risk factors (phosphocalcic abnormalities, anti-vitamin K)...
November 2018: Néphrologie & Thérapeutique
Samuel Delma, Corinne Isnard-Bagnis, Gilbert Deray, Raphaël Nail Barthelemy, Lucile Mercadal, Geoffroy Desbuissons
BACKGROUND: Calciphylaxis or calcific uremic arteriolopathy (CUA) is a cutaneous disease with ulcerations secondary to calcification of cutaneous and subcutaneous small arteries and arterioles. It is a rare but severe disease with significant morbidity and mortality affecting 1 to 4% of dialysis patients. The circumstances of occurrence are multiple. CASE: We report the case of a severe bilateral lower limb calciphylaxis in a 69-year-old, obese, hemodialysis patient with a recent diagnosis of Graves' disease complicated with hypercalcemia and cardiac arrhythmia requiring the use of vitamin K antagonist...
December 2018: Néphrologie & Thérapeutique
Claire Harris, Mercedeh Kiaii, Wynnie Lau, Myriam Farah
Background: Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare but life-threatening condition predominately occurring in patients with end-stage renal disease on dialysis. In the absence of randomized clinical trials to guide management, clinicians must rely on observational data. We have previously reported the outcomes of our multi-intervention management in seven patients and now present a larger series of patients with extended follow-up. Methods: We performed a retrospective analysis of all patients diagnosed with CUA at a single academic center between 2008 and 2017...
October 2018: Clinical Kidney Journal
Thijs T Jansz, Aegida Neradova, Adriana J van Ballegooijen, Marianne C Verhaar, Marc G Vervloet, Leon J Schurgers, Brigit C van Jaarsveld
BACKGROUND: Cardiovascular disease is the leading cause of death in end-stage renal disease and is strongly associated with vascular calcification. Both kidney transplantation and phosphate binders may lower the risk of vascular calcification. Vascular calcification is actively inhibited by vitamin-K-dependent matrix γ-carboxyglutamic acid protein (MGP). Whether kidney transplantation or phosphate binders affect vitamin K status is unknown. Therefore, we studied the influence of kidney transplantation and phosphate binder use on vitamin K status...
2018: PloS One
Vítor Ferreira, Cristiana Freixo, João Gonçalves, Gabriela Teixeira, Inês Antunes, Carlos Veiga, Daniel Mendes, Joana Martins, Rui Almeida
BACKGROUND: Optimal antithrombotic therapy after lower limb infrainguinal revascularization remains a controversial topic. The use of anticoagulants, alone or in combination with antiplatelet drugs, can potentially improve patency rate and limb salvage, particularly in patients with risk factors for early thrombosis. Bleeding is the main complication of long-term anticoagulant use. New oral anticoagulants can represent an attractive alternative to the standard vitamin K antagonists. The objective of the study is to evaluate the effectiveness (bypass occlusion and major amputation) and safety (major bleeding and all-cause mortality) of rivaroxaban compared to acenocumarol after infrainguinal lower limb surgical revascularization...
August 10, 2018: Annals of Vascular Surgery
Takayuki Hamano
Despite the advent of cinacalcet and noncalcium-containing phosphate binders, controlling the progression of vascular calcification (VC) is still challenging. Recent reports demonstrate that carbamylation driven by high urea concentration aggravates VC, suggesting the importance of adequate dialysis in retarding its progression. Theoretically, other promising measures include the use of iron-based phosphate binders, vitamin K, and magnesium supplements, which should be investigated in future randomized controlled trials (RCTs), ideally with hard outcomes...
November 2018: Seminars in Dialysis
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
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...
August 15, 2018: Internal Medicine
A Yajima, K Tsuchiya, L F Bonewald, M Inaba, Y Tominaga, T Tanizawa, A Ito, K Nitta
Evaluation of bone is of great importance in chronic kidney disease patients, as these patients are at an increased risk for fractures. We treated a hemodialysis patient suffering from hyperparathyroid bone disease with cinacalcet hydrochloride and concurrent administration of maxacalcitol and alfacalcidol for a year. Hyperparathyroid bone disease is characterized by cortical thinning, increased cortical porosity, reduced trabecular bone volume, and increased hypomineralized matrix volume, and there is little information to date about the effects of treatment with cinacalcet hydrochloride on the bone fragility in patients with hyperparathyroid bone disease...
May 2018: Osteoporosis International
Maria Fusaro, Maurizio Gallieni, Andrea Aghi, Giorgio Iervasi, Maria Antonietta Rizzo, Andrea Stucchi, Marianna Noale, Giovanni Tripepi, Thomas Nickolas, Nicola Veronese, Fabrizio Fabris, Sandro Giannini, Lorenzo Calò, Antonio Piccoli, Maria Cristina Mereu, Laura Cosmai, Alberto Ferraro, Fiorenza Magonara, Michela Spinello, Stefania Sella, Mario Plebani
BACKGROUND: Bone gamma-carboxyglutamic acid (Gla)-protein (BGP or osteocalcin) is a vitamin K-dependent protein involved in the regulation of bone mineralization. Smoking is a risk factor for osteoporosis. METHODS: We carried out a secondary analysis of the vitamin K Italian (VIKI) study to investigate the association between cigarette smoking and BGP levels in patients with end stage renal disease. Data were collected in 370 haemodialysis patients, 37% (136) smokers (or ex-smokers) and 63% (234) non-smokers...
September 19, 2017: Current Vascular Pharmacology
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
Mabel Aoun, Maha Makki, Hiba Azar, Hiam Matta, Dania Nehme Chelala
BACKGROUND: Vascular calcifications are highly prevalent in hemodialysis patients. Dephosphorylated-uncarboxylated MGP (dp-ucMGP) was found to increase in vitamin K-deficient patients and may be associated with vascular calcifications. Supplementation of hemodialysis patients with vitamin K2 (menaquinone-7) has been studied in Europe with a maximum 61% drop of dp-ucMGP levels. The aim of this study is to assess first the drop of dp-ucMGP in an Eastern Mediterranean cohort after vitamin K2 treatment and second the correlation between baseline dp-ucMGP and vascular calcification score...
June 7, 2017: BMC Nephrology
James E Novak, Khalid Alamiri, Jerry Yee
Dabigatran, a direct thrombin inhibitor and one of the new class of direct oral anticoagulants, is increasingly used in preference to warfarin because of its efficacy and ease of administration. However, because the drug is cleared by the kidneys, it can accumulate in plasma and increase the risk for bleeding in patients with decreased kidney function. We report a patient with end-stage liver disease who developed life-threatening hemorrhage and acute kidney injury while taking dabigatran, 150mg, twice daily...
January 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ramin Tajbakhsh, Mostafa Qorbani, Golbarg Mehrpour, Mitra Rahimzadeh, Mohammad Mehdi Azimzadeh, Hossein Mirmiranpour
The current study was conducted to assess the effect of hemodialysis (HD) on the status of plasma oxidants and antioxidants among patients with end-stage renal disease (ESRD). These parameters can have an influence on the HD process and can also be useful for follow-up of these patients. The participants of this cross-sectional study comprised 91 patients with a mean age of 51.1 ± 8.2 years on chronic HD with kt/v between 1.2 and 1.4. The etiology of ESRD in these patients was as follows: diabetes mellitus in 39, hypertension in 35, and glomerulonephritis in 17 patients...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
Zbylut J Twardowski
Warfarin is the most commonly used anticoagulant for prevention and therapy of thrombosis. Warfarin is a vitamin K antagonist and inhibits synthesis of clotting factors II, VII, IX, and X, and anticoagulant proteins C and S. Whereas there is extensive information about the efficacy of warfarin and target International Normalized Ratio (INR) for patients with artificial heart valves, atrial fibrillation, pulmonary emboli, deep venous thrombosis, and lupus anticoagulant, there is little in the literature on the role of warfarin in maintaining the patency of hemodialysis catheters...
January 2000: Hemodialysis International
Sagar U Nigwekar
PURPOSE OF REVIEW: Calciphylaxis remains a poorly understood vascular calcification disorder with predilection for patients with end-stage renal disease (ESRD). Recent data from large patient registries and databases have begun to provide information regarding incidence, risk factors, and outcomes in patients with calciphylaxis. RECENT FINDINGS: The most recent estimate places the incidence of calciphylaxis at 3.5 new cases/1000 patient-years among the patients with ESRD on chronic hemodialysis...
July 2017: Current Opinion in Nephrology and Hypertension
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