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https://www.readbyqxmd.com/read/28710090/the-clinical-and-economic-effect-of-vascular-access-selection-in-patients-initiating-hemodialysis-with-a-catheter
#1
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/28700182/-brachial-artery-pseudoaneurysm-a-rare-but-serious-complication-in-hemodialysis-patients-with-arteriovenous-fistula
#2
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
#3
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/28662308/gender-disparity-in-fistula-use-at-initiation-of-hemodialysis-varies-markedly-across-esrd-networks-analysis-of-usrds-data
#4
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/28648652/dialysis-related-parameters-influence-remodeling-in-the-venous-part-of-the-native-arteriovenous-fistula
#5
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/28639917/concomitant-staple-aneurysmorrhaphy-and-flow-calibrated-arteriovenous-fistula-banding-over-a-coronary-dilator-to-treat-hand-steal-syndrome
#6
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/28625819/outcomes-of-relocation-of-basilic-vein-in-brachiobasilic-fistulas-in-chronic-renal-failure
#7
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
https://www.readbyqxmd.com/read/28624422/endovascular-proximal-forearm-arteriovenous-fistula-for-hemodialysis-access-results-of-the-prospective-multicenter-novel-endovascular-access-trial-neat
#8
Charmaine E Lok, Dheeraj K Rajan, Jason Clement, Mercedeh Kiaii, Ravi Sidhu, Ken Thomson, George Buldo, Christine Dipchand, Louise Moist, Joanna Sasal
BACKGROUND: Hemodialysis arteriovenous fistulas (AVFs) are suboptimally used primarily due to problems with maturation, early thrombosis, and patient nonacceptance. An endovascular approach to fistula creation without open surgery offers another hemodialysis vascular access option. STUDY DESIGN: Prospective, single-arm, multicenter study (Novel Endovascular Access Trial [NEAT]). SETTINGS & PARTICIPANTS: Consecutive adult non-dialysis-dependent and dialysis-dependent patients referred for vascular access creation at 9 centers in Canada, Australia, and New Zealand...
June 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28599902/cost-effectiveness-analysis-of-vascular-access-referral-policies-in-ckd
#9
Steven M Shechter, Talon Chandler, M Reza Skandari, Nadia Zalunardo
BACKGROUND: The optimal timing of vascular access referral for patients with chronic kidney disease who may need hemodialysis (HD) is a pressing question in nephrology. Current referral policies have not been rigorously compared with respect to costs and benefits and do not consider patient-specific factors such as age. STUDY DESIGN: Monte Carlo simulation model. SETTING & POPULATION: Patients with chronic kidney disease, referred to a multidisciplinary kidney clinic in a universal health care system...
June 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28591486/computational-fluid-dynamic-analysis-of-the-hemodialysis-plastic-cannula
#10
David Fulker, Zakir Sayed, Anne Simmons, Tracie Barber
The jet of fluid returning to the patient through a hemodialysis venous needle has previously been reported as a potential source of endothelial damage which can lead to intimal hyperplasia (IH) in arteriovenous fistulae (AVF). Metal needles are the current standard practice for accessing the vascular system in hemodialysis. However, plastic cannulae have been used in Japan for 30 years. This study utilized computational fluid dynamics to analyze the hemodynamics of blood exiting a plastic cannula and determined the optimal placement and blood flow rate...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28580561/-using-interdisciplinary-cooperation-to-improve-the-rate-of-proper-performance-of-a-hand-exercise-among-hemodialysis-patients-with-arteriovenous-fistula-construction
#11
Ya-Hsin Hsiao, Miao-Ling Shin, Cyong-Pei Huang, Siang-Jyun Chen, Tsuey-Yuan Huang
BACKGROUND & PROBLEMS: Patients who undergo new arteriovenous fistula (AVF) construction as part of their hemodialysis treatment program are required to perform hand exercises properly in order to maintain AVF function. However, poor performance of these hand exercises currently results in the failure of many patients to preserve AVF function. PURPOSE: To increase the rate of performing this hand exercise properly from 55% to 80%. RESOLUTION: A comprehensive investigation identified the following five main problems: (a) Insufficient muscular endurance; (b) Resistance was not labeled on the ball; (c) Difficulties with maintaining a grip on the ball during the exercise; (d) Lack of standardized education procedures; and (e) Nurses lack latest knowledge on the hand exercise...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28574142/ultrasound-vector-flow-imaging-could-be-a-new-tool-in-evaluation-of-arteriovenous-fistulas-for-hemodialysis
#12
Ilaria Fiorina, Maria Vittoria Raciti, Alfredo Goddi, Vito Cantisani, Chandra Bortolotto, Shane Chu, Fabrizio Calliada
INTRODUCTION: We report the use of a new ultrasound technique to evaluate the axial and lateral components of a complex flow in the arteriovenous fistula (AVF). Vector Flow Imaging (VFI) allows to identify different components of the flow in every direction, even orthogonal to the flow streamline, represented by many single vectors. VFI could help to identify flow alterations in AVF, probably responsible for its malfunction. METHODS: From February to June 2016, 14 consecutive patients with upper-limb AVF were examined with a Resona 7 (Mindray, Shenzhen, China) ultrasound scanner equipped with VFI...
May 24, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28553035/brachiocephalic-arteriovenous-fistula-for-hemodialysis-through-the-median-antecubital-vein
#13
E Elamurugan, R Hemachandar
In patients unsuitable for radiocephalic fistula creation, the next option is brachiocephalic fistula. In such patients, we exploited the venous interconnections in the cubital fossa for median cubital vein-Brachiocephalic arteriovenous fistula (AVF) creation. In this article, we describe our experience in the creation of such technical variant of the brachiocephalic fistula AVF, its success and associated complications. A retrospective review of such AVF created between September 2014 and August 2015 was done...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28540993/administration-of-a-high-dose-erythropoietin-stimulating-agent-in-hemodialysis-patients-is-associated-with-late-arteriovenous-fistula-failure
#14
Hye Yun Jeong, Eun Jung Ko, Sang Hoon Kim, Mi Jung Lee, Hye Jeong Cho, Dong Ho Yang, So Young Lee
PURPOSE: Investigating the risk of vascular access failure is critical for maintenance hemodialysis (MHD) patients. Erythropoietin stimulating agents (ESA) typically used for anemia of chronic kidney disease (CKD) may also stimulate neointimal hyperplasia, which is the most important factor in late arteriovenous fistula (AVF) failure. The aim of this study was to investigate whether ESA treatment is associated with late AVF failure. MATERIALS AND METHODS: The late AVF failure group comprised 51 patients who underwent percutaneous intervention or surgery for fistula revision after successful use for at least three months...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28534129/insomnia-muscular-cramps-and-pruritus-have-low-intensity-in-hemodialysis-patients-with-good-dialysis-efficiency-low-inflammation-and-arteriovenous-fistula
#15
Olga Hilda Orasan, Aniela Pop Saplontai, Angela Cozma, Simona Racasan, Ina Maria Kacso, Crina Claudia Rusu, Diana Moldovan, Dacian Tirinescu, Alina Potra, Ioan Mihai Patiu, Remus Aurel Orasan
INTRODUCTION: Insomnia, muscular cramps, pruritus and postdialysis recovery time (RT) are quality-of-life parameters that affect hemodialysis (HD) patients physically and mentally. METHODS: We included 171 end-stage renal disease patients: 115 on high-flux HD and 56 on online hemodiafiltration (HDF). Patients were asked "How long does it take you to recover from a dialysis session?" and they evaluated intensity (absent, mild, medium and severe) of insomnia, muscular cramps and pruritus in the past 4 weeks...
May 22, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28527110/a-review-of-the-hemodynamic-factors-believed-to-contribute-to-vascular-access-dysfunction
#16
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/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#17
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/28498647/association-between-staphylococcus-aureus-bacteremia-and-hospital-mortality-in-hemodialysis-patients-with-bloodstream-infection-a-multicenter-cohort-from-japanese-tertiary-care-centers
#18
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/28480823/clinical-course-of-hemodialysis-access-after-initial-endovascular-intervention-for-stenosis-in-asian-renal-failure-patients
#19
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/28450292/cd44-promotes-inflammation-and-extracellular-matrix-production-during-arteriovenous-fistula-maturation
#20
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...
June 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
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