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Your search keyword '"Sy, John"' showing total 2 results
Start Over Author "Sy, John" Journal american journal of nephrology
2 results on '"Sy, John"'

1. Cardiovascular and Bleeding Outcomes with Anticoagulants across Kidney Disease Stages: Analysis of a National US Cohort.

Author

Sy, John, Hsiung, Jiu-Ting, Edgett, Drake, Kalantar-Zadeh, Kamyar, Streja, Elani, and Lau, Wei Ling

Subjects
Anticoagulation, Chronic kidney disease, Direct oral anticoagulant, Safety, Warfarin, Urology & Nephrology, Clinical Sciences
Abstract

BackgroundWhile direct oral anticoagulants (DOACs) are considered safe among patients without chronic kidney disease (CKD), the evidence is conflicting as to whether they are also safe in the CKD and end-stage kidney disease (ESKD) population. In this observational cohort study, we examined whether DOACs are a safe alternative to warfarin across CKD stages for a variety of anticoagulation indications.MethodsIndividuals on DOACs or warfarin were identified from OptumLabs® Data Warehouse (OLDW), a longitudinal dataset with de-identified administrative claims, from 2010 to 2017. Cox models with sensitivity analyses were used to assess the risk of cardiovascular disease and bleeding outcomes stratified by CKD stage.ResultsAmong 351,407 patients on anticoagulation, 45% were on DOACs. CKD stages 3-5 and ESKD patients comprised approximately 12% of the cohort. The most common indications for anticoagulation were atrial fibrillation (AF, 44%) and venous thromboembolism (VTE, 23%). DOACs were associated with a 22% decrease in the risk of cardiovascular outcomes (HR 0.78, 95% CI: 0.77-0.80, p < 0.001) and a 10% decrease in the risk of bleeding outcomes (HR 0.90, 95% CI: 0.88-0.92, p < 0.001) compared to warfarin after adjustment. On stratified analyses, DOACs maintained a superior safety profile across CKD stages. Patients with AF on DOACs had a consistently lower risk of cardiovascular and bleeding events than warfarin-treated patients, while among other indications (VTE, peripheral vascular disease, and arterial embolism), the risk of cardiovascular and bleeding events was the same among DOAC and warfarin users.ConclusionDOACs may be a safer alternative to warfarin even among CKD and ESKD patients.

Published
2021

2. Ultrafiltration Rate Effects Declines in Residual Kidney Function in Hemodialysis Patients

Author

Lee, Yuji, Okuda, Yusuke, Sy, John, Kim, Sung Rok, Obi, Yoshitsugu, Kovesdy, Csaba P, Rhee, Connie M, Streja, Elani, and Kalantar-Zadeh, Kamyar

Subjects
Kidney Disease, Bioengineering, Clinical Research, Assistive Technology, Renal and urogenital, Good Health and Well Being, Adult, Aged, Disease Progression, Female, Glomerular Filtration Rate, Hemodiafiltration, Humans, Kidney, Kidney Failure, Chronic, Linear Models, Male, Middle Aged, Regional Blood Flow, Renal Elimination, Retrospective Studies, Urea, Hemodialysis, Residual kidney function, Ultrafiltration rate, Clinical Sciences, Urology & Nephrology
Abstract

BACKGROUND:High ultrafiltration rate (UFR) has been associated with increased mortality in hemodialysis (HD) patients. However, the impact of UFR on decline of residual kidney function (RKF) has not been elucidated among patients receiving conventional HD. METHODS:We performed a retrospective cohort study of 7,753 patients who initiated conventional HD from 2007 to 2011 and survived the first year of dialysis with baseline UFR and renal urea clearance (KRU) data at baseline and 1 year (5th patient-quarter). The primary exposure was average UFR at the 1st patient-quarter from dialysis initiation (

Published
2019

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