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Catheter related infections in hemodialysis patients

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https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#1
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28684919/point-prevalence-of-complications-between-the-y-connection-technique-and-the-usual-care-technique-for-blood-restitution-in-patients-of-an-outpatient-hemodialysis-unit-a-comparison
#2
Nadine Tacchini-Jacquier, Henk Verloo
BACKGROUND: Central venous catheter-related infections (CVCIs) in patients on maintenance hemodialysis (HD) have been documented due to unsafe/unsterile manipulations by nurses during HD machine deconnection and reconnection. Given the gravity of CVCIs in HD patients using catheter access, precise, safe installation of the device, and good nursing technique are crucial. AIM: To assess and compare safety performance and complications of a Y-connection (n=133) versus the usual tunneled central venous catheter (CVC) technique (n=73) among HD patients and then explore preferences between techniques among patients and frontline HD nurses...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28679363/incremental-short-daily-home-hemodialysis-a-case-series
#3
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/28676513/antibiotic-lock-in-tenckhoff-catheter-for-biofilm-associated-peritonitis
#4
Steve Siu-Man Wong, Wai-Yan Lau, Ping-Kwan Chan, Ching-Kit Wan, Yuk-Lun Cheng
Biofilm bacteria in the Tenckhoff catheter are notoriously difficult to eradicate. They are the potential sources of relapsing or repeat peritonitis among peritoneal dialysis (PD) patients. Inadequate penetration into biofilms by standard intraperitoneal antibiotics, as well as a lack of effective adjunctive treatment, leads to a high rate of Tenckhoff catheter loss as a result of biofilm bacteria. In hemodialysis, on the other hand, catheter-related bloodstream infection caused by biofilm bacteria does not necessarily lead to a loss of catheter...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28663227/national-healthcare-safety-network-nhsn-dialysis-event-surveillance-report-for-2014
#5
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/28566082/-femoral-hemodialysis-catheter-related-bacteremia-due-to-globicatella-sanguinis-challenges-in-species-identification
#6
Elif Aktaş, Nafia Canan Gürsoy, Tamer Sakacı, Yener Koç, Aziz Ahmad Hamidi, Emin Bulut, Duygu Erdemir, Barış Otlu
In this case, catheter-related bacteremia due to Globicatella sanguinis in a 43 years old female patient undergoing hemodialysis with the diagnosis of diabetic nephropathy was presented and the methods in the laboratory diagnosis of the rare opportunistic pathogen, Globicatella cins, were nvestigated. A set of peripheral blood cultures and simultaneous catheter culture was obtained from the patient in third of May 2016. Biochemical tests, Phoenix (Becton Dickinson, USA) and MicroScan (Beckman Coulter, USA) automated systems and matrix assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF MS) based Microflex MS (Bruker, Daltonics, Germany) and VITEK MS (database v2...
April 2017: Mikrobiyoloji Bülteni
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
#7
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/28509133/denosumab-for-treatment-of-immobilization-related-hypercalcemia-in-a-patient-with-end-stage-renal-disease
#8
Atsuko Uehara, Masahiko Yazawa, Atsumi Kawata, Rina Hachisuka, Yugo Shibagaki
The efficacy and safety of denosumab for the treatment of immobilization-related hypercalcemia in end-stage renal disease remain uncertain. We describe the case of a hemodialysis patient with immobilization-related hypercalcemia who was successfully treated with denosumab. A 79-year-old man admitted for hemodialysis after sustaining an acute kidney injury developed immobilization-related hypercalcemia due to the impairment resulting from an acute myocardial infarction, acute heart failure, and catheter-related bloodstream infection...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28418628/catheter-related-fungal-endocarditis-caused-by-candida-parapsilosis-in-a-hemodialysis-patient
#9
Ying Shu, Shaobin Yu, Ling Zha, Ping Fu, Tianlei Cui
Fungal endocarditis (FE) is commonly regarded as a rare but fatal disease. The incidence of infective endocarditis (IE) in hemodialysis (HD) patients is thought to be obviously higher than that in the general population. Moreover, IE occurs more likely in HD patients with catheters. With the increase of HD population and extensive use of catheters in HD patients, FE, as a special form of IE, may increase and bring new challenges to clinicians. We reported a case of FE associated with catheter infection in a 44-year-old woman on HD...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28408711/a-randomized-controlled-trial-to-determine-the-appropriate-time-to-initiate-peritoneal-dialysis-after-insertion-of-catheter-timely-pd-study
#10
Dwarakanathan Ranganathan, George T John, Edward Yeoh, Nicola Williams, Barry O'Loughlin, Thin Han, Lakshmanan Jeyaseelan, Kavitha Ramanathan, Helen Healy
BACKGROUND: The optimal time for the commencement of peritoneal dialysis (PD) after PD catheter insertion is unclear. If dialysis is started too soon after insertion, dialysate leaks and infection could occur. However, by starting PD earlier, morbidity and costs can be reduced through lesser hemodialysis requirements. This is the first randomized controlled trial to determine the safest and shortest interval to commence PD after catheter insertion. METHODS: All consecutive patients undergoing PD catheter insertion at the Royal Brisbane and Women's Hospital and Rockhampton Hospital from 1 March 2008 to 31 May 2013 who met the inclusion and exclusion criteria were invited to participate in the trial...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28362044/comparison-of-post-creation-procedures-and-costs-between-surgical-and-an-endovascular-approach-to-arteriovenous-fistula-creation
#11
Shuo Yang, Charmaine Lok, Renee Arnold, Dheeraj Rajan, Marc Glickman
INTRODUCTION: Due to early and late failures that may occur with surgically created hemodialysis arteriovenous fistulas (SAVF), post-creation procedures are commonly required to facilitate AVF maturation and maintain patency. This study compared AVF post-creation procedures and their associated costs in patients with SAVF to patients with a new endovascularly created AVF (endoAVF). METHODS: A 5% random sample from Medicare Standard Analytical Files was abstracted to determine post-creation procedures and associated costs for SAVF created from 2011 to 2013...
March 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28356667/hemophagocytic-lymphohistiocytosis-secondary-to-hemodialysis-catheter-related-blood-stream-infection
#12
U Anandh, S Johari, B Vaswani
A 57-year-old man on dialysis presented with fever due to Pseudomonas septicemia. Workup revealed very high triglycerides and serum ferritin levels. A bone marrow examination showed hemophagocytosis. A diagnosis of hemophagocytic lymphohistiocytosis (HLH) was made and steroids were started. He was put on automated peritoneal dialysis. Patients' condition continued to deteriorate and he succumbed to his illness. This case illustrates the development of HLH secondary to infections which are increasingly being recognized in the literature...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28355409/life-saving-vascular-access-in-vascular-capital-exhaustion-single-center-experience-in-intra-atrial-catheters-for-hemodialysis
#13
Marta Pereira, Noélia Lopez, Iolanda Godinho, Sofia Jorge, Estela Nogueira, Fernando Neves, Alice Fortes, António G Costa
INTRODUCTION: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. OBJECTIVE: To assess the complications of IAC placement, as well as patient and vascular access survival after this procedure. METHODS: The authors retrospectively analyzed all seven patients with vascular capital exhaustion, without immediate alternative renal replacement therapy (RRT), who underwent IAC placement between January 2004 and December 2015 at a single center...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28346468/endoluminal-dilatation-for-embedded-hemodialysis-catheters-a-case-control-study-of-factors-associated-with-embedding-and-clinical-outcomes
#14
Hari Talreja, Stephen Edward Ryan, Janet Graham, Manish M Sood, Adnan Hadziomerovic, Edward Clark, Swapnil Hiremath
BACKGROUND: With the increasing frequency of tunneled hemodialysis catheter use there is a parallel increase in the need for removal and/or exchange. A small but significant minority of catheters become embedded or 'stuck' and cannot be removed by traditional means. Management of embedded catheters involves cutting the catheter, burying the retained fragment with a subsequent increased risk of infections and thrombosis. Endoluminal dilatation may provide a potential safe and effective technique for removing embedded catheters, however, to date, there is a paucity of data...
2017: PloS One
https://www.readbyqxmd.com/read/28297057/dialysis-access-issues-related-to-conversion-from-peritoneal-dialysis-to-hemodialysis-and-vice-versa
#15
Maurizio Gallieni, Antonino Giordano, Anna Ricchiuto, Davide Gobatti, Maurizio Cariati
ABSTRACTHemodialysis (HD) and peritoneal dialysis (PD) represent two complementary modalities of renal replacement therapy (RRT) for end-stage renal disease patients. Conversion between the two modalities is frequent and more likely to happen from PD to HD. Every year, 10% of PD patients convert to HD, suggesting the need for recommendations on how to proceed with the creation of a vascular access in these patients. Criteria for selecting patients who would likely fail PD, and therefore take advantage of a backup access, are undefined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297055/any-use-for-alternative-lock-solutions-in-the-prevention-of-catheter-related-blood-stream-infections
#16
Laura Labriola, Jean-Michel Pochet
The prevention of catheter-related blood stream infections (CRBSI) in hemodialysis (HD) patients remains a challenge because of high morbidity and mortality associated to CRBSI. Alternative locking solutions (ALS) containing an antithrombotic substance with additional antimicrobial or antibiofilm properties (citrate, ethylenediaminetetraacetic acid [EDTA], 70% ethanol, thrombolytics) with or without the addition of molecules with specific antimicrobial activity (antibiotics, taurolidine, paraben-methylene-blue) has been proposed with the aim to prevent or eradicate intraluminal biofilm colonization and subsequent CRBSI...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28194286/central-venous-catheter-related-bloodstream-infection-with-kocuria-kristinae-in-a-patient-with-propionic-acidemia
#17
Masato Kimura, Eichiro Kawai, Hisao Yaoita, Natsuko Ichinoi, Osamu Sakamoto, Shigeo Kure
Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 months prior to the onset of symptoms because of repeated acute pancreatitis...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28165583/chlorhexidine-impregnated-transparent-dressings-decrease-catheter-related-infections-in-hemodialysis-patients-a-quality-improvement-project
#18
Ibironke W Apata, John Hanfelt, James L Bailey, Vandana Dua Niyyar
PURPOSE: Central venous catheters (CVC) are associated with increased infection rates, morbidity and mortality compared to other hemodialysis vascular access. Chlorhexidine-impregnated transparent (CHG-transparent) dressings allow for continuous antimicrobial exposure and easy visibility of the CVC insertion site. We conducted a quality improvement project to compare catheter-related infection (CRI) rates in two dressing regimens - CHG-transparent dressings and adhesive dry gauze dressing in hemodialysis patients with tunneled CVCs...
February 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28135701/catheter-failure-and-mortality-in-hemodialysis-patients-with-tunneled-cuffed-venous-catheters-in-a-single-center
#19
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...
2017: Blood Purification
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
#20
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
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