There are multiple considerations in the setting of a CVA in a patient requiring hemodialysis. One is addressing potentially high intracerebral pressure (ICP). A slow reduction in BUN to avoid osmotic-related brain cell swelling and an associated rise in ICP may be addressed in a variety of ways. Lo...

The official guidance (package insert) is to "use caution" in patients with a CVA - not particularly use advice, is it? Other than the risk of exacerbating hypertension, I see no acute risk of ESAs with a CVA. However, having a CVA clearly places a patient in a relatively high risk of another. This ...

If there is concern or evidence for high intracranial pressures then it is very important not to lower serum osmolality too fast. There is a number of ways of addressing this issue. Some examples are slow dialysis, hypertonic saline infusion while doing dialysis, continuous renal replacement therapy...