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https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#1
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28218365/a-comparison-of-efficacy-of-endovascular-versus-surgical-repair-for-the-treatment-of-arteriovenous-fistula-stenosis-in-taiwan
#2
Szu-Shan Fan, Chien-Wen Chen, Kuo-Cheng Lu, Hung-Chung Mao, Miao-Pei Chen, Chu-Lin Chou
BACKGROUND: Percutaneous transluminal angioplasty (PTA) and fistula reconstruction surgery are therapeutic options for vascular access occlusion in hemodialysis patients. However, owing to its convenience, PTA has gradually become the preferred therapeutic option for fistula stenosis or occlusion. This study investigated the effects of the two therapeutic methods on the vascular access maintenance duration (number of days) and maintenance costs of fistula in dialysis patients from different dialysis units...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28218364/stenoses-in-the-surgically-manipulated-segment-have-better-angioplasty-response-compared-to-the-surgically-naive-segment-in-fistulas
#3
Jie Cui, Dihua Xu, Jie Ma, Bingyan Liu, Tatsuo Kawai, Heidi Yeh, Robert Schainfeld, Zubin Irani
PURPOSE: Balloon angioplasty is the standard treatment for dysfunctional hemodialysis fistulas, but angioplasty response of stenotic lesions located in different segments of the dialysis circuit has not been explicitly evaluated. The purpose of this study is to describe the distribution of stenotic lesions in the most common types of arteriovenous fistulas and to investigate the response to balloon angioplasty of stenotic lesions located in various segments of the fistula circuit. MATERIALS AND METHODS: This single-center, retrospective study was approved by the Institutional Review Board...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28218363/sex-race-and-hemodialysis-vascular-access-processes
#4
Rita L McGill, Eduardo Lacson
PURPOSE: Hemodialysis (HD) patients who are female or black receive fewer arteriovenous fistulas (AVF) and more grafts (AVG). We evaluated race- and sex-based differences for three process exposures: access surgery, peripherally-inserted central catheters (PICCs), and vascular imaging. METHODS: US Renal Data System with linked Medicare claims for patients initiating HD between April 2010 - December 2011 were used to identify PICC placement, imaging, AVF and AVG surgeries, and the vascular accesses in use at individual HD treatments...
February 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28217059/ultrasound-guided-axillary-brachial-plexus-block-versus-local-infiltration-anesthesia-for-arteriovenous-fistula-creation-at-the-forearm-for-hemodialysis-in-patients-with-chronic-renal-failure
#5
W H Nofal, S M El Fawal, A A Shoukry, Eas Sabek, Wfa Malak
BACKGROUND: The primary failure rate for arteriovenous fistula (AVF) creation under local anesthesia for hemodialysis is about 30%. Axillary brachial plexus block (BPB) may improve blood flow through blood vessels used in fistula creation; it may improve the AVF blood flow and thus may reduce the primary failure rate after 3 months. METHODS: Hundred and forty patients with chronic renal failure scheduled for AVF creation for hemodialysis were divided into two equal groups; Group 1 (AxBP-G) received ultrasound (US) guided axillary BPB, and Group 2 (LI-G) received local infiltration...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28185405/evaluation-of-long-term-combination-therapy-with-peritoneal-dialysis-and-hemodialysis
#6
Reo Kanda, Hiroaki Io, Junichiro Nakata, Yuko Makita, Yu Sasaki, Mayumi Matsumoto, Keiichi Wakabayashi, Yasuhiko Tomino, Yusuke Suzuki
It is well known that a combination therapy with peritoneal dialysis (PD) and hemodialysis (HD) is feasible and may improve clinical status in patients for whom adequate solute and fluid removal is difficult to achieve with PD alone. The objective of the present study was to evaluate whether the therapy is useful in the likelihood of long-term peritoneal membrane and cardiac function. The therapy was 6 days of PD and one session of HD per week. Physical, biochemical, dialysate-to-plasma ratio of creatinine (D/P Cr), arteriovenous fistula (AVF) blood flow, and left ventricular mass index (LVMI) data were prospectively analyzed in 30 patients with measurements performed at 0 and 6 months, and for 21 patients, 12 or 18 months after initiation of the therapy...
February 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28183219/cilostazol-may-improve-maturation-rates-and-durability-of-vascular-access-for-hemodialysis
#7
Todd E Russell, Gregory C Kasper, Andrew J Seiwert, Anthony J Comerota, Fedor Lurie
Cilostazol is effective in controlling pathophysiological pathways similar or identical to those involved in nonmaturation and failure of the arteriovenous access. This case-control study examined whether cilostazol would improve maturation rates and durability of vascular access for hemodialysis. The treatment group included 33 patients who received cilostazol for ≥30 days prior to creation of a dialysis access and continued with cilostazol therapy for ≥60 days after surgery. The matched (gender, age, race, diabetes, and the year of surgery) control group included 116 patients who underwent the same procedure but did not receive cilostazol prior to and at least 3 months after surgery...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28174402/-coronary-pulmonary-artery-fistula-in-a-hemodialysis-patient
#8
Ryuichi Yoshimura, Yoshihiro Naruse, Keita Tanaka, Yangsin Lee
We report a case of coronary-pulmonary artery fistula in a hemodialysis patient treated surgically. A 47-year-old man was admitted with chest pain and exertional dyspnea that progressively worsened over the previous 2 months. He had a history of end-stage renal disease and has been on hemodialysis for 5 years. Coronary angiography and computed tomography revealed coronary-pulmonary artery fistula that originated from both the left anterior descending coronary artery and the right coronary artery. Under cardiopulmonary bypass, we opened the pulmonary artery and closed the fistula...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28163173/increased-oxidative-stress-and-hypoxia-inducible-factor-1-expression-during-arteriovenous-fistula-maturation
#9
Nirvana Sadaghianloo, Kota Yamamoto, Hualong Bai, Masayuki Tsuneki, Clinton D Protack, Michael R Hall, Serge Declemy, Réda Hassen-Khodja, Joseph Madri, Alan Dardik
BACKGROUND: The poor clinical results that are frequently reported for arteriovenous fistulae (AVF) for hemodialysis are typically due to failure of AVF maturation. We hypothesized that early AVF maturation is associated with generation of reactive oxygen species and activation of the HIF-1 pathway, potentially promoting neointimal hyperplasia. We tested this hypothesis using a previously reported mouse AVF model that recapitulates human AVF maturation. METHODS: Aortocaval fistulae were created in C57Bl/6 mice, and compared to sham-operated mice...
February 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28143967/the-effect-of-predialysis-fistula-attempt-on-risk-of-all-cause-and-access-related-death
#10
Robert R Quinn, Matthew J Oliver, Daniel Devoe, Krishnan Poinen, Rameez Kabani, Fareed Kamar, Priyanka Mysore, Adriane M Lewin, Swapnil Hiremath, Jennifer MacRae, Matthew T James, Lisa Miller, Brenda R Hemmelgarn, Louise M Moist, Amit X Garg, Tanvir T Chowdhury, Pietro Ravani
Whether the lower risk of mortality associated with arteriovenous fistula use in hemodialysis patients is due to the avoidance of catheters or if healthier patients are simply more likely to have fistulas placed is unknown. To provide clarification, we determined the proportion of access-related deaths in a retrospective cohort study of patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. A total of 3168 patients initiated dialysis at the participating centers; 2300 met our inclusion criteria...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28135701/catheter-failure-and-mortality-in-hemodialysis-patients-with-tunneled-cuffed-venous-catheters-in-a-single-center
#11
Min Shi, Tianlei Cui, Liang Ma, Li Zhou, Ping Fu
BACKGROUND: As of now, only a few studies have focused on the failure of tunneled cuffed venous catheter (tCVC) and mortality of hemodialysis (HD) patients using tCVC as long-term vascular access, whose vascular condition for arteriovenous fistula was not very satisfactory. In this study, we aimed to provide information about the first tCVC failure and survival rates of patients in this population. METHODS: Fifty-nine patients who used tCVC from January 1, 2009 to December 31, 2014 in our HD center were analyzed in this retrospective study and followed up either until their death or until December 31, 2015...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28133903/hypoproteinemia-as-a-prognostic-risk-factor-for-arteriovenous-fistula-failure
#12
Vedran Premuzic, Tvrtko Hudolin, Josip Pasini, Zoran Zimak, Dinko Hauptman, Bojan Jelakovic, Zeljko Kastelan
INTRODUCTION: Any vascular access is of limited duration with many factors which influence survival in patients on chronic hemodialysis (HD). Hypoproteinemia as a marker of chronic illness is common among chronic HD patients. Our aim was to analyze the survival of the primary arteriovenous fistula (AVFs) and the risk factors which influence their patency and to test the hypothesis that patients with normal values of serum proteins have lower risk of AVF failure compared to patients with hypoproteinemia...
January 29, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28124305/calcification-in-arteriovenous-fistula-blood-vessels-may-predict-arteriovenous-fistula-failure-a-5-year-follow-up-study
#13
Aleksandar Jankovic, Tatjana Damjanovic, Zivka Djuric, Jelena Marinkovic, Georg Schlieper, Petar Djuric, Jelena Tosic Dragovic, Ana Bulatovic, Milos Mitrovic, Jovan Popovic, Jürgen Floege, Nada Dimkovic
PURPOSE: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. The impact of vascular calcification process on AVF survival remains unclear and results of several studies about this issue are controversial. In the light of the new knowledge about the different susceptibility for calcification process in different blood vessels, the aim of our study was to analyze whether the calcification of AVF-blood vessels may have an impact on AVF longevity. METHODS: The study included 90 patients, 49 males and 41 females, all of them Caucasians, with a mean age 62 ± 11 years, on regular hemodialysis for more than 1 year with patent primary AVFs...
January 25, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28115002/left-innominate-vein-stenosis-in-an-asymptomatic-population-a-retrospective-analysis-of-212-cases
#14
Xiangjiang Guo, Yaxue Shi, Hui Xie, Lan Zhang, Guanhua Xue, Leyi Gu, Changning Hao, Shuofei Yang, Kejia Kan
BACKGROUND: Although left innominate vein (LIV) stenosis has been demonstrated to be attributed to compression by adjacent anatomical structures, most of the studies are focusing on hemodialysis patients with clinical symptoms compatible with LIV stenosis. The goal of this study was to retrospectively investigate the incidence of LIV stenosis and its influencing factors in an asymptomatic, non-hemodialysis population, which has rarely been performed. METHODS: From Jan 2013 to Dec 2014, 212 consecutive cases undergoing a chest multi-detector computed tomography (MDCT) angiography were enrolled...
January 23, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28110327/mortality-after-renal-allograft-failure-and-return-to-dialysis
#15
Amarpali Brar, Mariana Markell, Dimitre G Stefanov, Edem Timpo, Rahul M Jindal, Robert Nee, Nabil Sumrani, Devon John, Fasika Tedla, Moro O Salifu
INTRODUCTION: The outcomes of patients who fail their kidney transplant and return to dialysis (RTD) has not been investigated in a nationally representative sample. We hypothesized that variations in management of transplant chronic kidney disease stage 5 leading to kidney allograft failure (KAF) and RTD, such as access, nutrition, timing of dialysis, and anemia management predict long-term survival. METHODS: We used an incident cohort of patients from the United States Renal Data System who initiated hemodialysis between January 1, 2003 and December 31, 2008, after KAF...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28078825/ethanol-combined-with-heparin-as-a-locking-solution-for-the-prevention-of-catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-randomized-study
#16
Sofia Sofroniadou, Ioanna Revela, Alexandros Kouloubinis, Ioanna Makriniotou, Sinodi Zerbala, Despina Smirloglou, Petros Kalocheretis, Apostolos Drouzas, George Samonis, Christos Iatrou
Introduction Ethanol lock solution has been mainly administered in paediatric and home parenteral nutrition patients in order to prevent catheter related blood stream infections (CRBSI). Its utility in hemodialysis (HD) patients with non-tunneled-uncuffed catheter (NTC) has been poorly explored. Methods We conducted a prospective randomized study in chronic HD patients requiring a newly inserted NTC-while awaiting for the maturation of an already established arteriovenous fistula (AVF) or arteriovenous graft (AVG) or tunneled-cuffed catheter insertion...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#17
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28064472/arteriovenous-grafts-much-maligned-but-in-need-of-reconsideration
#18
Michael Allon
There are substantial variations in arteriovenous fistula (AVF) use among hemodialysis patients in different countries, in different regions of the U.S., and even in different hemodialysis units within a single metropolitan area. These variations persist after adjustment for patient demographics and comorbidities, suggesting that practice patterns play a major role in determining the frequency of AVF use. These observations led to vascular access guidelines urging nephrologists and surgeons to increase AVF creation in patients with chronic kidney disease...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28062678/facility-practice-variation-to-help-understand-the-effects-of-public-policy-insights-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#19
Douglas S Fuller, Bruce M Robinson
Recent Centers for Medicare & Medicaid Services policies have used dialysis facility practice variation to develop public ratings and adjust payments. In the Dialysis Facility Compare star rating system (DFC SRS), facility-relative rates of performance-based clinical measures varied nearly two-fold for mortality (standardized mortality ratio; 10th/90th percentiles: 0.71, 1.34) and hospitalization (standardized hospitalization ratio; 10th/90th percentiles: 0.64, 1.37), and nearly four-fold for transfusion (standardized transfusion ratio; 10th/90th percentiles: 0...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28058709/surgeon-experience-affects-outcome-of-forearm-arteriovenous-fistulae-more-than-outcomes-of-upper-arm-fistulae
#20
Susanne Regus, Veronika Almási-Sperling, Ulrich Rother, Alexander Meyer, Werner Lang
INTRODUCTION: There is still an ongoing discussion about the influence of vascular surgeon experience on the immediate and long-term outcome of newly created arteriovenous fistula (AVF) for patients on hemodialysis (HD). The aim of this study was to compare failure and patency rates of AVF between experienced consultants and resident trainees with special focus on location of the anastomosis on the forearm or upper arm. METHODS: Between November 2012 and September 2016, 159 patients (83 on HD and 76 preemptive) received an AVF (90 radiocephalic [RCAVF] on the forearm; 69 brachiocephalic [BCAVF] in the elbow) by two experienced vascular surgeons (group A; n = 74) or five residents in training with one-to-four years of experience (group B; n = 85)...
January 3, 2017: Journal of Vascular Access
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