Title: Dabigatran and Hemodialysis: Watch for the Rebound<br/>Author: Bryan Hayes<br/><a href='http://umem.org/profiles/faculty/369/'>[Click to email author]</a><hr/><p>
In patients receiving renal replacement therapy as a treatment modality for dabigatran-related bleeding, watch for a rebound concentration increase after hemodialysis is stopped.</p>
<p>
<strong>More than 50% of patients demonstrate a rebound effect with a median increase in dabigatran concentration of 33%</strong>.</p>
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<p>
It is unclear whether this rebound effect is clinically important, and whether it translates to prolonged clinically relevant bleeding. Extended hemodialysis sessions or consideration of CVVHD should offset this potential problem.</p>
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<p>
<u>Bonus Pearl</u>:</p>
<p>
The North American Congress of Clinical Toxicology starts today and runs through October 12. Look for toxicology pearls and updates on Twitter under the official conference hashtag #NACCT15.</p>
<fieldset><legend>References</legend>
<p>
Chai- Adisaksopha C, et al. Hemodialysis for the treatment of dabigatran-associated bleeding: a case report and systematic review. <em>J Thromb Haemost </em>2015;13(10):1790-8. [<a href="http://www.ncbi.nlm.nih.gov/pubmed/26270886">PMID 26270886</a>]</p>
<p>
<strong>Follow me on Twitter (<a href="https://twitter.com/PharmERToxGuy">@PharmERToxGuy</a>)</strong></p>
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