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Case Reports
. 2014 Aug 20:2:18-22.
doi: 10.5414/CNCS108253. eCollection 2014.

Use of hemodialysis for the treatment of intracerebral hemorrhage in patients on dabigatran with normal renal function

Thin Thin Maw  1 , Brian L Henry  2 , Tripti Singh  3
Affiliations
Case Reports

Use of hemodialysis for the treatment of intracerebral hemorrhage in patients on dabigatran with normal renal function

Thin Thin Maw et al. Clin Nephrol Case Stud. .

Abstract

Dabigatran is a direct thrombin inhibitor which is approved by the Food and Drug Administration (FDA) for prevention of embolic stroke in patients with atrial fibrillation. Dabigatran has been shown to be non- inferior to warfarin in preventing stroke in patients with atrial fibrillation [1, 6]. The rate of major bleeding in patients taking dabigatran is also similar to that seen in patients on warfarin [1]. Unlike warfarin, there is currently no antidote available for reversal of anticoagulant effects of dabigatran [2, 3]. Dabigatran is excreted renally and accumulates in patients with acute kidney injury (AKI). Hemodialysis has been reported to increase clearance of dabigatran in patients with acute kidney injury and life-threatening bleeding [4, 5]. We present two cases of dabigatran-associated intracranial hemorrhage where hemodialysis was used to accelerate clearance of dabigatran from the blood in patients with normal renal function.

Keywords: dabigatran; hemodialysis; intracerebral hemorrhage.

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