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fistula for hemodialysis

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https://www.readbyqxmd.com/read/28739575/fda-regulatory-perspectives-for-studies-on-hemodialysis-vascular-access
#1
Frank P Hurst, Robert E Lee, Aliza M Thompson, Brian D Pullin, Douglas M Silverstein
In an effort to foster innovation and new product development, the American Society of Nephrology and the US Food and Drug Administration partnered to form the Kidney Health Initiative in 2012. Part of the Kidney Health Initiative's mission is to foster development of therapies by creating a collaborative environment where the US Food and Drug Administration and the greater nephrology community can interact to optimize product evaluation. This particular Kidney Health Initiative project focused on products related to hemodialysis vascular access, with the goal of clarifying appropriate trial end points that could subsequently inform clinical, regulatory, and coverage decisions...
July 24, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28725317/prevalence-of-metabolic-syndrome-among-the-end-stage-renal-disease-patients-on-hemodialysis
#2
Khaled A Alswat, Awwadh Althobaiti, Khulod Alsaadi, Amaal Saeed Alkhaldi, Maryam Mutlaq Alharthi, Walaa Abduraheem Abuharba, Ahmed A Alzaidi
BACKGROUND: Patients with metabolic syndrome (MetS) have a 2.6-fold greater risk of incident chronic kidney disease (CKD). The primary goal of this study was to assess the prevalence of MetS in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) and the impact of MetS presence on HD-related outcomes. METHODS: This is a cross-sectional study conducted in the Dialysis Center, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia. It was conducted among ESRD patients that attended the Dialysis Center between August 2013 and September 2016...
August 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28724774/histopathology-of-veins-obtained-at-hemodialysis-arteriovenous-fistula-creation-surgery
#3
Charles E Alpers, Peter B Imrey, Kelly L Hudkins, Tomasz A Wietecha, Milena Radeva, Michael Allon, Alfred K Cheung, Laura M Dember, Prabir Roy-Chaudhury, Yan-Ting Shiu, Christi M Terry, Alik Farber, Gerald J Beck, Harold I Feldman, John W Kusek, Jonathan Himmelfarb
Stenosis from venous neointimal hyperplasia is common in native arteriovenous fistulas (AVFs). However, the preexisting histologic characteristics of veins at fistula creation, and associations thereof with baseline patient factors, have not been well characterized. In this study, we conducted histologic analysis of a segment of the vein used for anastomosis creation, obtained during AVF creation from 554 of the 602 participants in the multicenter Hemodialysis Fistula Maturation Cohort Study. We quantified intimal and medial areas and lengths of the internal and external elastic lamina by morphometry and assessed venous wall cells by immunohistochemistry, extracellular matrix with Movat stain, and calcium deposition by alizarin red stain...
July 19, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28710091/intimal-hyperplasia-stenosis-and-arteriovenous-fistula-maturation-failure-in-the-hemodialysis-fistula-maturation-study
#4
Alfred K Cheung, Peter B Imrey, Charles E Alpers, Michelle L Robbin, Milena Radeva, Brett Larive, Yan-Ting Shiu, Michael Allon, Laura M Dember, Tom Greene, Jonathan Himmelfarb, Prabir Roy-Chaudhury, Christi M Terry, Miguel A Vazquez, John W Kusek, Harold I Feldman
Intimal hyperplasia and stenosis are often cited as causes of arteriovenous fistula maturation failure, but definitive evidence is lacking. We examined the associations among preexisting venous intimal hyperplasia, fistula venous stenosis after creation, and clinical maturation failure. The Hemodialysis Fistula Maturation Study prospectively observed 602 men and women through arteriovenous fistula creation surgery and their postoperative course. A segment of the vein used to create the fistula was collected intraoperatively for histomorphometric examination...
July 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28710090/the-clinical-and-economic-effect-of-vascular-access-selection-in-patients-initiating-hemodialysis-with-a-catheter
#5
Alian Al-Balas, Timmy Lee, Carlton J Young, Jeffrey A Kepes, Jill Barker-Finkel, Michael Allon
Patients in the United States frequently initiate hemodialysis with a central venous catheter (CVC) and subsequently undergo placement of a new arteriovenous fistula (AVF) or arteriovenous graft (AVG). Little is known about the clinical and economic effects of initial vascular access choice. We identified 479 patients starting hemodialysis with a CVC at a large medical center (during 2004-2012) who subsequently had an AVF (n=295) or AVG (n=105) placed or no arteriovenous access (CVC group, n=71). Compared with patients receiving an AVG, those receiving an AVF had more frequent surgical access procedures per year (1...
July 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28705077/fifty-years-of-hemodialysis-access-literature-the-fifty-most-cited-publications-in-the-medical-literature
#6
Edvard Skripochnik, David J O'Connor, Eric B Trestman, Evan C Lipsitz, Larry A Scher
Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28700182/-brachial-artery-pseudoaneurysm-a-rare-but-serious-complication-in-hemodialysis-patients-with-arteriovenous-fistula
#7
Andrea Mancini, Giuseppe Castriotta, Pernina Angelini, Michele Bozzi, Vincenzo Giancaspro, Elvira La Raia, Maria Teresa Nisi, Anna Rita Proscia, Giuseppe Tarantino, Ottavia Vitale, Cristoforo Cuzzola
A pseudoaneurysm or false aneurysm of the brachial artery is an uncommon occurrence in patients receiving hemodialysis with arteriovenous fistula (AVF). We describe the case of a 76-year-old woman presenting with a large, tender, pulsatile mass in the right antecubital region 10 cm from the AVF. B-mode ultrasound examination revealed a saccular hematoma. Color doppler showed a recirculation movement of blood, creating a two colors image called "Korean flag". The patient was transferred to the surgical unit where she first underwent ultrasound-guided compression and then surgical repair of the pseudoaneurysm...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#8
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28680868/comparison-of-the-effects-of-hegu-point-ice-massage-and-2-lidocaine-gel-on-arteriovenous-fistula-puncture-related-pain-in-hemodialysis-patients-a-randomized-controlled-trial
#9
Vajihe Arab, Masoumeh Bagheri-Nesami, Seyed Nouraddine Mousavinasab, Fatemeh Espahbodi, Zahra Pouresmail
Introduction: There is a paucity of information on the effects of Hegu point ice massage and 2% lidocaine gel on fistula puncture-related pain in hemodialysis patients. The aim of the present research was compare the two methods in terms of their effectiveness. Methods: This study is a randomized controlled trial. Seventy hemodialysis patients were divided into two groups. The fistula puncture-related pain in the two groups was measured in the first session of hemodialysis without any intervention. During a hemodialysis session, 2% lidocaine gel was applied on the patient's arteriovenous fistula site in one group...
June 2017: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28679363/incremental-short-daily-home-hemodialysis-a-case-series
#10
Stephanie M Toth-Manikowski, Surekha Mullangi, Seungyoung Hwang, Tariq Shafi
BACKGROUND: Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. CASE PRESENTATION: From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen...
July 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28666501/spontaneous-rupture-and-dissection-of-aspergillus-infected-arteriovenous-fistula
#11
Syed Nayer Mahmud, Behzad Kaleem Baloch, Muhammed Safdar, Muhammed Saeed
Patients with end stage renal disease need a vascular access like arteriovenous (AV) fistula, AV graft or central venous catheter for hemodialysis. However, AV fistula can be complicated due to infection, stenosis, ulceration etc. Among these, spontaneous rupture of AV fistula is rare and can be due to stenosis or infection. Fungal infection of AV fistula is very rare and the most common organism involved is Candida. Infection of native AV fistula with Aspergillusis not reported in the literature. This case discusses the spontaneous rupture and dissection of an Aspergillusinfected arteriovenous fistula, requiring urgent closure and repairing of vessel...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28665461/clinical-predictors-of-recurrent-stenosis-and-need-for-re-intervention-in-the-cephalic-arch-in-patients-with-brachiocephalic-av-fistulas
#12
Saravanan Balamuthusamy, Alagarsamy Lakku Reddi, Machaiah H Madhrira, Balamurugan Sankarapandian, Peter Nguyen, Avinash Vallurupalli, William Gabbard, Nishant Jalandhara, Albert Yurvati
INTRODUCTION: Cephalic arch stenosis is one of the most common reasons for repeated endovascular intervention and eventual abandonment of access in hemodialysis patients. There is no prediction model to identify risk factors for recurrent cephalic arch stenosis. We have developed a mathematical model to predict the need for reintervention in brachiocephalic (BC) fistulas with recurrent cephalic arch stenosis. METHODS: Single-center retrospective analysis of 143 patients with a BC fistula referred to the vascular clinic for access dysfunction who underwent cephalic arch angioplasty were included for the analysis...
June 23, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28663227/national-healthcare-safety-network-nhsn-dialysis-event-surveillance-report-for-2014
#13
Duc B Nguyen, Alicia Shugart, Christi Lines, Ami B Shah, Jonathan Edwards, Daniel Pollock, Dawn Sievert, Priti R Patel
BACKGROUND AND OBJECTIVES: Persons receiving outpatient hemodialysis are at risk for bloodstream and vascular access infections. The Centers for Disease Control and Prevention conducts surveillance for these infections through the National Healthcare Safety Network. We summarize 2014 data submitted to National Healthcare Safety Network Dialysis Event Surveillance. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Dialysis facilities report three types of dialysis events (bloodstream infections; intravenous antimicrobial starts; and pus, redness, or increased swelling at the hemodialysis vascular access site)...
June 29, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28662308/gender-disparity-in-fistula-use-at-initiation-of-hemodialysis-varies-markedly-across-esrd-networks-analysis-of-usrds-data
#14
Mariana Markell, Amarpali Brar, Dimitre G Stefanov, Moro O Salifu
BACKGROUND: Gender disparities had been noted in the care of women with end stage renal disease (ESRD) in the early 2000's, including less frequent initiation of hemodialysis utilizing a fistula but more recent data have not been examined and underlying factors have not been extensively studied. STUDY DESIGN: Data from the United States Renal Data System (USRDS) were examined, including 202,999 hemodialysis patients. Only those who had received prior nephrology care were included...
June 29, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28652058/repeated-paradoxical-brain-infarctions-in-a-patient-on-self-managed-home-hemodialysis-using-a-long-term-indwelling-catheter
#15
Takuya Kiyohara, Tadataka Mizoguchi, Junya Kuroda, Yoshinobu Wakisaka, Aya Irie, Chie Kitaoka, Kiichiro Fujisaki, Udai Nakamura, Kazuhiko Tsuruya, Takanari Kitazono, Tetsuro Ago
We describe the case of a 51-year-old Japanese man with an end-stage kidney disease caused by a 30-year history of type 1 diabetes mellitus. The patient had suffered repeated bilateral multiple brain infarctions within a short period of time after the initiation of a self-managed daily home hemodialysis regimen using a long-term indwelling catheter inserted into the right atrium. Despite extensive examinations, we could not find any embolic causes except for the catheter and a patent foramen ovale (PFO). The patient had experienced repeated brain infarctions under antiplatelet and anticoagulation therapies, but suffered no further brain infarctions after the removal of the catheter and the alteration of vascular access from the catheter to an arteriovenous fistula in the forearm...
June 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28648652/dialysis-related-parameters-influence-remodeling-in-the-venous-part-of-the-native-arteriovenous-fistula
#16
Tomasz Gołębiowski, Mariusz Kusztal, Krzysztof Letachowicz, Hanna Augustyniak-Bartosik, Maciej Szymczak, Magdalena Krajewska, Wojciech Marcinkowski, Wacław Weyde, Marian Klinger
AIM: The aim of this study was to evaluate the association of hemodynamic parameters related to hemodialysis and antropometric parameters of patients with changes in the venous part of the arteriovenous fistula (AVF) at points of needling. MATERIAL AND METHODS: 242 HD patients (60.3% men), with median age 65 [IQR 56-75] years, on HD treatment for a median of 49 [IQR 20-88] months with functioning fistula were recruited to the study. The history of vascular access, comorbidity, antropometric (BMI, BSA, body composition) and dialysis-related parameters were analyzed...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647193/cryopreserved-venous-allograft-is-an-acceptable-conduit-in-patients-with-current-or-prior-angioaccess-graft-infection
#17
Michael P Harlander-Locke, Peter F Lawrence, Aamna Ali, Esther Bae, James Kohn, Christopher Abularrage, Michael Ricci, Gary W Lemmon, Sotero Peralta, Jeffrey Hsu
OBJECTIVE: The durability of cryopreserved allograft has been previously demonstrated in the setting of infection. The objective of this study was to examine the safety, efficacy, patency, and cost per day of graft patency associated with using cryopreserved allograft (vein and artery) for hemodialysis access in patients with no autogenous tissue for native fistula creation and with arteriovenous graft infection or in patients at high risk for infection. METHODS: Patients implanted with cryopreserved allograft for hemodialysis access between January 2004 and January 2014 were reviewed using a standardized, multi-institutional database that evaluated demographic, comorbidity, procedural, and outcomes data...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28639917/concomitant-staple-aneurysmorrhaphy-and-flow-calibrated-arteriovenous-fistula-banding-over-a-coronary-dilator-to-treat-hand-steal-syndrome
#18
Jennifer Baker, Rafael D Malgor
BACKGROUND: True venous aneurysm formation can occur in patients with arteriovenous fistulas (AVFs) for hemodialysis but association with steal syndrome is uncommon. METHODS: To describe a case of a patient on chronic hemodialysis through a right brachiocephalic fistula, who presents with associated steal syndrome and true arteriovenous access aneurysm. RESULTS: A 34-year-old female with true AVF aneurysm presented with hand steal syndrome confirmed by noninvasive studies...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28639916/benefits-of-long-versus-short-thrombolysis-times-for-acutely-thrombosed-hemodialysis-native-fistulas
#19
Susanne Regus, Werner Lang, Marco Heinz, Michael Uder, Axel Schmid
INTRODUCTION: Local thrombolysis with a time of exposure to recombinant tissue plasminogen activator of 15 to 150 minutes is commonly used to declot acutely thrombosed hemodialysis fistulas. The duration of thrombolysis for the restoration of arteriovenous blood flow remains controversial. The aim of this study was to investigate the outcomes of long thrombolysis treatment (LTT, 3 hours or more) and short thrombolysis treatment (STT, less than 3 hours) in our institution. METHODS: We retrospectively analyzed 86 interventional declotting procedures (28 STT and 58 LTT) applied to 86 acutely thrombosed hemodialysis fistulas...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28625819/outcomes-of-relocation-of-basilic-vein-in-brachiobasilic-fistulas-in-chronic-renal-failure
#20
Farzad Kakaei, Ahad Hasankhani, Mir-Salim Seyyed-Sadeghi, Peyman Virani, Tooraj Asvadi, Sina Zarrintan
BACKGROUND: In patients without or with injured cephalic vein, using the basilic vein for creating arteriovenous fistula (AVF) is the best way for hemodialysis. In order to create AVF, the basilic vein should be superficialized and lateralized. This study sought to examine outcome of relocation of basilic vein in brachiobasilic fistulas in patients with chronic renal failure (CRF). METHODS: We evaluated the outcome of creation of brachiobasilic fistula with transposition of basilic vein in 27 patients (14 males and 13 females with mean age of 60...
June 15, 2017: International Journal of Surgery
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