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https://www.readbyqxmd.com/read/28527110/a-review-of-the-hemodynamic-factors-believed-to-contribute-to-vascular-access-dysfunction
#1
Connor V Cunnane, Eoghan M Cunnane, Michael T Walsh
A vascular access (VA) is used to facilitate hemodialysis in patients that suffer from end-stage renal disease. However, they suffer from high failure rates due to non-maturation and venous stenosis, with intimal hyperplasia (IH) the underlying cause of both conditions. Abnormal hemodynamic profiles, which arise following VA creation, are believed to lead to the development of IH. However, the exact physiological response that initiates this process is unknown. This review evaluates the different hemodynamic parameters that are hypothesised to correlate with the development of IH...
May 19, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28522655/choice-of-hemodialysis-access-in-older-adults-a-cost-effectiveness-analysis
#2
Rasheeda K Hall, Evan R Myers, Sylvia E Rosas, Ann M O'Hare, Cathleen S Colón-Emeric
BACKGROUND AND OBJECTIVES: Although arteriovenous fistulas have been found to be the most cost-effective form of hemodialysis access, the relative benefits of placing an arteriovenous fistula versus an arteriovenous graft seem to be least certain for older adults and when placed preemptively. However, older adults' life expectancy is heterogeneous, and most patients do not undergo permanent access creation until after dialysis initiation. We evaluated cost-effectiveness of arteriovenous fistula placement after dialysis initiation in older adults as a function of age and life expectancy...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28522650/examining-the-association-between-hemodialysis-access-type-and-mortality-the-role-of-access-complications
#3
Pietro Ravani, Robert Quinn, Matthew Oliver, Bruce Robinson, Ronald Pisoni, Neesh Pannu, Jennifer MacRae, Braden Manns, Brenda Hemmelgarn, Matthew James, Marcello Tonelli, Brenda Gillespie
BACKGROUND AND OBJECTIVES: People receiving hemodialysis to treat kidney failure need a vascular access (a fistula, a graft, or a central venous catheter) to connect to the blood purification machine. Higher rates of access complications are considered the mechanism responsible for the excess mortality observed among catheter or graft users versus fistula users. We tested this hypothesis using mediation analysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied incident patients who started hemodialysis therapy from North America, Europe, and Australasia (the Dialysis Outcomes and Practice Patterns Study; 1996-2011)...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#4
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
May 18, 2017: Nephron
https://www.readbyqxmd.com/read/28514783/dialysis-access-as-an-area-of-improvement-in-elderly-incident-hemodialysis-patients-results-from-a-cohort-study-from-the-international-monitoring-dialysis-outcomes-initiative
#5
Jochen G Raimann, Claudia Barth, Len A Usvyat, Priscila Preciado, Bernard Canaud, Michael Etter, Xiaoqi Xu, Adrian Guinsburg, Christina Marelli, Neill Duncan, Albert Power, Frank M van der Sande, Jeroen P Kooman, Stephan Thijssen, Yuedong Wang, Peter Kotanko
BACKGROUND: Commencing hemodialysis (HD) using a catheter is associated with a higher risk of adverse outcomes, and early conversion from central-venous catheter (CVC) to arteriovenous fistula/graft (non-CVC) improves outcomes. We investigated CVC prevalence and conversion, and their effects on outcomes during the first year of HD in a multinational cohort of elderly patients. METHODS: Patients ≥70 years from the MONDO Initiative who commenced HD between 2000 and 2010 in Asia-Pacific, Europe, North-, and South-America and survived at least 6 months were included in this investigation...
May 17, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28498647/association-between-staphylococcus-aureus-bacteremia-and-hospital-mortality-in-hemodialysis-patients-with-bloodstream-infection-a-multicenter-cohort-from-japanese-tertiary-care-centers
#6
Takahiro Imaizumi, Takeshi Hasegawa, Atsushi Nomura, Sho Sasaki, Hiroki Nishiwaki, Takaya Ozeki, Hideaki Shimizu, Shun Minatoguchi, Taishi Yamakawa, Masahiko Yazawa, Daisuke Uchida, Hiroo Kawarazaki, Masahito Miyamoto, Tomo Suzuki, Ken'ichiro Koitabashi, Masahide Furusho, Yoshiro Fujita
Multiple studies have shown that Staphylococcus aureus bacteremia (SAB) has been a major cause of death in hemodialysis patients. We examined whether SAB is a risk for mortality among chronic hemodialysis patients in Japan where the standard vascular access is arteriovenous fistula (AVF). This was a multicenter, retrospective study of maintenance hemodialysis patients with bloodstream infection (BSI) from 2011 to 2013 at tertiary care centers in Japan. The endpoint was hospital mortality. Our cohort contained 32 SAB cases (14 MRSA and 18 MSSA) and 42 non-SAB cases...
May 12, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28489644/an-open-source-ultrasound-software-for-diagnosis-of-fistula-maturation
#7
Barry Belmont, Dae Woo Park, William F Weitzel, Albert J Shih
Vascular access is essential for hemodialysis patients. The mature native arteriovenous fistula has been the preferred vascular access for hemodialysis, because it has greater longevity than synthetic grafts. However, once surgically created, fistulas often fail to develop (mature) into viable points of vascular access, requiring surgical or radiologic interventions before their use. Because maturation depends on vascular mechanics (e.g., distensibility and wall shear), we developed open-source ultrasound software to investigate these metrics clinically...
May 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28480823/clinical-course-of-hemodialysis-access-after-initial-endovascular-intervention-for-stenosis-in-asian-renal-failure-patients
#8
Dewahar Senthoor, Kyi Zin Thant, Tze-Kiat Ng, Pei Ho
BACKGROUND: Arteriovenous fistula (AVF) and arteriovenous fistula graft (AVG) access for hemodialysis can develop stenosis, eventually leading to thrombosis and access failure. Prompt endovascular intervention can salvage the access but restenosis does occur. Clinical course, restenosis pattern, and risk factors associated with initial stenosis of AVFs/AVGs in Asian hemodialysis patients were studied. METHOD: A retrospective study was conducted (January 2009-June 2012) on consecutive patients with renal failure who developed the first-time stenosis in the vascular access and were managed with endovascular intervention...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28469489/sternocostoclavicular-hyperostosis-an-insufficiently-recognized-clinical-entity
#9
Taro Sugase, Tetsu Akimoto, Hidenori Kanazawa, Atsushi Kotoda, Daisuke Nagata
A 79-year-old male chronic hemodialysis patient with no history of central venous catheterization was referred to our hospital with progressive swelling of the left upper limb ipsilateral to a forearm arteriovenous fistula. Radiological assessments revealed marked hyperostosis in the ribs, sternum, and clavicles with well-developed ossification of the sternocostoclavicular ligaments. Such characteristic structural abnormalities and our failure to identify the left subclavian vein with contrast material despite the abundant dilated collaterals in the left shoulder area encouraged us to diagnose our patient with sternocostoclavicular hyperostosis (SCCH) complicated by central vein obstruction...
2017: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28466757/applicability-of-an-entry-flow-model-of-the-brachial-artery-for-flow-models-of-the-hemodialysis-fistula
#10
Sulav Bastola, William D Paulson, Steven A Jones
The native arteriovenous fistula creates a shunt that provides the high blood flow that is needed for dialysis. Lumped parameter hemodynamic models of the arteriovenous fistula can be used to predict shear stresses and pressure losses and can be applied to help understand unsolved problems such as the high rate of arteriovenous fistula maturation failure. These models combine together flow components, such as arteries, stenosis, anastomoses, arterial compliance, and blood inertia, and each component must be modeled with an appropriate pressure-flow relationship...
May 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28462878/-vascular-steal-syndrome-due-to-the-creation-of-an-arteriovenous-shunt-for-hemodialysis-patient-information-and-nephrologist-responsibility
#11
Alexandre Seidowsky, Eve Vilaine, Sarah Adoff, Emmanuel Dupuis, Caroline Bidault, Cédric Villain, Raphaël Coscas
Although responsibility is a fundamental determinant in medical practice, physicians are generally unfamiliar with its principles. The same is true for disclosure requirements and requests for compensation in the event of physical injury. We report on a representative survey of iatrogenic complications that may arise after the implementation of vascular access for haemodialysis and that illustrate's the physician's responsibility and obligation to inform the patient. Vascular access steal syndrome is a serious complication of arteriovenous fistulas, and physicians may not be sufficiently aware of the likelihood of its occurrence...
April 24, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28457410/immunomodulation-acute-renal-failure-and-complications-of-basiliximab-use-after-liver-transplantation-analysis-of-114-patients-and-literature-review
#12
E C de Ataide, S R Perales, J B Bortoto, M A O Peres, F C Filho, R S B Stucchi, E Udo, I F S F Boin
Basiliximab is considered to be effective in preventing cellular rejection (CR) in solid organ transplantation and is commonly used for renal transplants. The aim of this study was describe the population of patients undergoing orthotopic liver transplantation (LT) receiving basiliximab in the period 2012-2016 in the liver transplant service at the State University of Campinas, São Paulo, Brazil. We analyzed 114 patients who underwent LT and received basiliximab; 83 (72.8%) were male and 31 (27.2%) female, with an overall mean age of 54...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28450292/cd44-promotes-inflammation-and-extracellular-matrix-production-during-arteriovenous-fistula-maturation
#13
Go Kuwahara, Takuya Hashimoto, Masayuki Tsuneki, Kota Yamamoto, Roland Assi, Trenton R Foster, Jesse J Hanisch, Hualong Bai, Haidi Hu, Clinton D Protack, Michael R Hall, John S Schardt, Steven M Jay, Joseph A Madri, Shohta Kodama, Alan Dardik
OBJECTIVE: Arteriovenous fistulae (AVF) remain the optimal conduit for hemodialysis access but continue to demonstrate poor patency and poor rates of maturation. We hypothesized that CD44, a widely expressed cellular adhesion molecule that serves as a major receptor for extracellular matrix components, promotes wall thickening and extracellular matrix deposition during AVF maturation. APPROACH AND RESULTS: AVF were created via needle puncture in wild-type C57BL/6J and CD44 knockout mice...
April 27, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28434704/establishment-of-buttonhole-technique-as-a-puncture-alternative-for-arteriovenous-f%C3%A3-stulas-experience-of-a-centre-over-3years
#14
Laura Baena, José L Merino, Blanca Bueno, Beatriz Martín, Verónica Sánchez, Luca Caserta, Beatriz Espejo, Patricia Domínguez, Alicia Gómez, Vicente Paraíso
INTRODUCTION: The buttonhole (BH) puncture technique for arteriovenous fistulas is an alternative to the classical staggered puncture. PURPOSE: We present 3years' results incorporating the BH puncture technique for arteriovenous fistulas in our dialysis unit. MATERIAL AND METHODS: Twenty-two patients were started on BH technique, 15 men and 7 women (mean age: 62 years; SD: 12), with time spent on dialysis when starting the BH technique of 34 months (SD: 34, median: 27, range: 3-136)...
March 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28430311/effect-of-hemodialysis-access-blood-flow-on-cardiac-events-after-coronary-artery-bypass-grafting-using-an-internal-thoracic-artery
#15
Leonid Feldman, Ilia Beberashvili, Ahmad Abu Tair, Shai Efrati, Oleg Gorelik, Walter G Wasser, Eitan Heldenberg, Igor Rabin
BACKGROUND: The possibility of coronary steal through an arteriovenous fistula (AVF) in hemodialysis (HD) patients with coronary artery bypass grafts (CABGs) using an ipsilateral internal thoracic artery (ITA) has been suggested. In order to define the significance of such a possibility, we analyzed cardiac events and mortality risk in patients in relation to AVF flow. METHODS: A retrospective cohort study was performed on prevalent HD patients from a single center...
April 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430307/the-incidence-and-risk-factors-of-coronary-steal-after-ipsilateral-avf-in-patients-with-a-coronary-artery-bypass-graft
#16
Sanghyun Ahn, Ahram Han, Song-Yi Kim, Chanjoong Choi, Sang-Il Min, Jongwon Ha, Ho Young Hwang, Ki-Bong Kim, Seung-Kee Min
OBJECTIVE: Ipsilateral arteriovenous fistula (AVF) may cause symptoms of coronary steal in patients who had undergone coronary artery bypass graft (CABG) using internal thoracic artery. The purpose of this study was to evaluate the adverse effects of ipsilateral AVF to CABG, including the incidence of coronary steal, and to analyze the risk factors for coronary steal. METHODS: Between 2000 and 2013, a total of 25 patients undergoing hemodialysis via upper extremity AVF, ipsilateral to the preexisting CABG, were reviewed retrospectively...
April 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28420654/changes-in-the-profile-of-endovascular-procedures-performed-in-freestanding-dialysis-access-centers-over-15-years
#17
Gerald A Beathard, Aris Urbanes, Terry Litchfield
BACKGROUND AND OBJECTIVES: Marked changes occurred in the vascular access profile of patients receiving hemodialysis in the United States over the 15-year period of 2001-2015. This study was undertaken to evaluate how these changes have affected dialysis access maintenance and salvage procedures performed in freestanding dialysis access centers and to examine the effectiveness, efficiency, and safety of these procedures in this setting. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were collected from freestanding, dedicated dialysis access centers operating under a common system of management...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28415162/value-of-doppler-evaluation-of-physically-abnormal-fistula-hemodynamic-guidelines-and-access-outcomes
#18
Seong Cho, Yu-Ji Lee, Sung-Rok Kim
Background/Aims: The strategy of access care at out center involves the use of ultrasound (USG) in case of physical examination (PE) abnormality. USG determines the need of angiography. This study investigated the possible association between the need for percutaneous transluminal angioplasty (PTA) and hemodynamic parameters of USG. The study also assessed the effects of this monitoring strategy on outcomes in comparison with a historical control. Methods: A retrospective study of the medical records of 127 patients (65 PTA, 62 non-PTA) was conducted...
April 18, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28409042/nephrologists-hate-the-dialysis-catheters-a-systemic-review-of-dialysis-catheter-associated-infective-endocarditis
#19
Kalyana C Janga, Ankur Sinha, Sheldon Greenberg, Kavita Sharma
A 53-year-old Egyptian female with end stage renal disease, one month after start of hemodialysis via an internal jugular catheter, presented with fever and shortness of breath. She developed desquamating vesiculobullous lesions, widespread on her body. She was in profound septic shock and broad spectrum antibiotics were started with appropriate fluid replenishment. An echocardiogram revealed bulky leaflets of the mitral valve with a highly mobile vegetation about 2.3 cm long attached to the anterior leaflet...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28393400/sonography-of-arteriovenous-fistulas-and-grafts
#20
Jason A Pietryga, Mark D Little, Michelle L Robbin
Arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) are the vascular accesses of choice for long-term hemodialysis. Strategies to establish and maintain functioning AVFs and AVGs are essential. In addition to clinical evaluation, ultrasound plays a critical role in the evaluation and maintenance of AVFs and AVGs. AVFs have a high rate of failure to mature which can be reliably diagnosed with ultrasound. Treatable etiologies of the failure to mature can often be diagnosed with ultrasound. Causes of secondary AVG failure can also be diagnosed with ultrasound and treated...
April 10, 2017: Seminars in Dialysis
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