Document Detail


Atrial fibrillation in hemodialysis patients: clinical features and associations with anticoagulant therapy.
MedLine Citation:
PMID:  20054291     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS), we determined incidence, prevalence, and outcomes among hemodialysis patients with atrial fibrillation. Cox proportional hazards models, to identify associations with newly diagnosed atrial fibrillation and clinical outcomes, were stratified by country and study phase and adjusted for descriptive characteristics and comorbidities. Of 17,513 randomly sampled patients, 2188 had preexisting atrial fibrillation, with wide variation in prevalence across countries. Advanced age, non-black race, higher facility mean dialysate calcium, prosthetic heart valves, and valvular heart disease were associated with higher risk of new atrial fibrillation. Atrial fibrillation at study enrollment was positively associated with all-cause mortality and stroke. The CHADS2 score identified approximately equal-size groups of hemodialysis patients with atrial fibrillation with low (less than 2) and higher risk (more than 4) for subsequent strokes on a per 100 patient-year basis. Among patients with atrial fibrillation, warfarin use was associated with a significantly higher stroke risk, particularly in those over 75 years of age. Our study shows that atrial fibrillation is common and associated with elevated risk of adverse clinical outcomes, and this risk is even higher among elderly patients prescribed warfarin. The effectiveness and safety of warfarin in hemodialysis patients require additional investigation.
Authors:
Volker Wizemann; Lin Tong; Sudtida Satayathum; Alex Disney; Takashi Akiba; Rachel B Fissell; Peter G Kerr; Eric W Young; Bruce M Robinson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-06
Journal Detail:
Title:  Kidney international     Volume:  77     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-28     Completed Date:  2010-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1098-106     Citation Subset:  IM    
Affiliation:
Georg Haas Dialysezentrum, Giessen, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Anticoagulants / adverse effects,  therapeutic use
Atrial Fibrillation / drug therapy,  epidemiology*
Data Collection
Humans
Incidence
Kidney Failure / complications*,  therapy
Middle Aged
Mortality
Prevalence
Renal Dialysis
Stroke / etiology
Treatment Outcome
Warfarin / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Fabrication and operation of an oxygen insert for adherent cellular cultures.
Next Document:  Endothelial cells as vascular salt sensors.