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https://www.readbyqxmd.com/read/28355409/life-saving-vascular-access-in-vascular-capital-exhaustion-single-center-experience-in-intra-atrial-catheters-for-hemodialysis
#1
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/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#2
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28298324/the-esrd-quality-incentive-program-can-we-bridge-the-chasm
#3
Daniel Weiner, Suzanne Watnick
The ESRD Quality Incentive Program (QIP) is the first mandatory federal pay for performance program launched on January 1, 2012. The QIP is tied to the ESRD prospective payment system and mandated by the Medicare Improvements for Patients and Providers Act of 2008, which directed the Centers for Medicare and Medicaid Services to expand the payment bundle for renal dialysis services and legislated that payment be tied to quality measures. The QIP links 2% of the payment that a dialysis facility receives for Medicare patients on dialysis to the facility's performance on quality of care measures...
March 15, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28248208/extracorporeal-liver-support-systems-in-paediatric-liver-failure
#4
Vandana Jain, Anil Dhawan
Extracorporeal liver support systems (ELSS), encompassing artificial and bio-artificial devices, have been used for decades, with the aim of supporting patients with acute liver failure (ALF) and acute-on chronic liver failure (AoCLF), as a bridge to recovery (ALF only) or liver transplantation (LT), in an era of organ donation shortage. Although biochemical efficacy has been consistently demonstrated by these devices, translation into clinical and survival benefits has been unclear, due to study limitations and lack of reliable prognostic scoring in liver failure...
December 21, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28209134/first-clinical-experience-in-14-patients-treated-with-advos-a-study-on-feasibility-safety-and-efficacy-of-a-new-type-of-albumin-dialysis
#5
Wolfgang Huber, Benedikt Henschel, Roland Schmid, Ahmed Al-Chalabi
BACKGROUND: Liver failure (LF) is associated with prolonged hospital stay, increased cost and substantial mortality. Due to the limited number of donor organs, extracorporeal liver support is suggested as an appealing concept to "bridge to transplant" or to avoid transplant in case of recovery. ADVanced Organ Support (ADVOS) is a new type of albumin dialysis, that provides rapid regeneration of toxin-binding albumin by two purification circuits altering the binding capacities of albumin by biochemical (changing of pH) and physical (changing of temperature) modulation of the dialysate...
February 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28152573/survival-probabilities-of-end-stage-renal-disease-patients-on-renal-replacement-therapy-in-iran
#6
Alireza Heidary Rouchi, Mohammad Ali Mansournia, Mohammad Aghighi, Mitra Mahdavi-Mazdeh
BACKGROUND: To bridge the gap in the current knowledge, the present study was conducted to obtain evidences relating to clinical outcomes of the ESRD population in Iran over the last two decades. METHODS: The records of 84,652 incident ESRD patients from 1995 up to and including 2014 in the national registry of ESRD patients were analyzed retrospectively. Data were collected from dialysis and transplant centers in Iran from 1995 to 2008 via paper forms and from 2009 to 2014 through web-based records...
February 2, 2017: Nephrology
https://www.readbyqxmd.com/read/28001025/clinical-benefits-of-phosphate-control-in-progression-of-end-stage-renal-disease
#7
Piergiorgio Bolasco, Stefano Murtas
It is largely agreed that preservation of residual kidney function (RKF) has a directly proportional affect on general, and in particular cardiovascular, mortality. During evaluation of patients on infrequent hemodialysis (ID) as both as once-weekly or twice-weekly hemodialysis it has been frequently underestimated the importance of phosphaturia, Indeed, the native kidney preserves the ability to eliminate not only toxic molecules but also a significative output of phosphate despite of a severe decrease of RKF...
June 2017: Panminerva Medica
https://www.readbyqxmd.com/read/27951576/future-trends-in-vascular-access-creation
#8
Surendra Shenoy
Delivery of a prescribed dialysis dose, which is critical for longevity on hemodialysis, is directly dependent on vascular access (VA). However, VA is fraught with high failure rates and has room for innovation. Arteriovenous fistula (AVF), considered the 'best choice', has a high 'failure to mature' rate. Arteriovenous grafts (AVGs) are considered when patients are poor candidates for or have failed AVF, but have a high incidence of infections and thrombosis. Due to associated morbidity and mortality from complications, central venous catheters are considered only as 'bridging short-term access' when there is an urgent need for dialysis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951552/what-is-the-best-dialysis-therapy-for-south-asia-hd-or-pd
#9
K R N Pavan, S V Subhramanyam, A N Karopadi, K A Sinoj, K S Nayak
BACKGROUND: South Asian countries have a population of 1.7 billion and are classified as low-middle to poor income nations. Their health care systems cannot presently meet the growing need for renal replacement therapy (RRT), provided as haemodialysis or peritoneal dialysis (PD). Most patients cannot afford the treatment and quickly default. Furthermore, most of the population is located in rural areas, where there are few treatment centres; therefore, there is a huge gap between those treated and those in need...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#10
Bailey E Sparks, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter)...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27765177/survival-after-orthotopic-heart-transplantation-in-patients-undergoing-bridge-to-transplantation-with-the-heartware-hvad-versus-the-heartmate-ii
#11
J Trent Magruder, Joshua C Grimm, Todd C Crawford, Ryan J Tedford, Stuart D Russell, Christopher M Sciortino, Glenn J R Whitman, Ashish S Shah
BACKGROUND: Our objective was to determine whether the choice of a HeartWare HVAD as opposed to a Heartmate II left ventricular assist device (HMII LVAD), impacts survival after heart transplantation after controlling for patient, donor, and center characteristics. METHODS: We queried the United Network for Organ Sharing (UNOS) database, which has recently made pretransplantation device duration available, for all adult patients undergoing bridge to transplantation (BTT) between January 2011 and March 2016...
October 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27712637/survival-risk-factors-and-effect-of-treatment-in-101-patients-with-calciphylaxis
#12
James T McCarthy, Rokea A El-Azhary, Michelle T Patzelt, Amy L Weaver, Robert C Albright, Alina D Bridges, Paul L Claus, Mark D P Davis, John J Dillon, Ziad M El-Zoghby, LaTonya J Hickson, Rajiv Kumar, Robert D McBane, Kathleen A M McCarthy-Fruin, Marian T McEvoy, Mark R Pittelkow, David A Wetter, Amy W Williams
OBJECTIVE: To report on the survival and the associations of treatments upon survival of patients with calciphylaxis seen at a single center. PATIENTS AND METHODS: Using the International Classification of Diseases, Ninth Revision diagnosis code of 275.49 and the keyword "calciphylaxis" in the dismissal narrative, we retrospectively identified 101 patients with calciphylaxis seen at our institution between January 1, 1999, through September 20, 2014, using a predefined, consensus-developed classification scheme...
October 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27631450/-organ-replacement-therapy-extracorporeal-liver-assist-devices
#13
REVIEW
Barbara Sinner, Gabriele I Kirchner
Liver failure is a disease with a high mortality rate. Often liver transplantation is the sole therapeutic option. On the one hand, liver support systems probably support the liver to allow regeneration, on the other hand they are an option to bridge for transplantation. This article gives an overview on the clinically used liver assist devices (molecular adsorbent recirculating system [MARS], Prometheus system, single-pass albumin dialysis [SPAD], plasmapheresis) and discusses the applications in liver failure...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27493118/%C3%A2-early-initiation-of-mars%C3%A2-dialysis-in-amanita-phalloides-induced-acute-liver-injury-prevents-liver-transplantation
#14
Mike Hendrik Pillukat, Tina Schomacher, Peter Baier, Gert Gabriëls, Hermann Pavenstädt, Hartmut H J Schmidt
 Amanita phalloides is the most relevant mushroom intoxication leading to acute liver failure. The two principal groups of toxins, the amatoxins and the phallotoxins, are small oligopeptides highly resistant to chemical and physical influences. The amatoxins inhibit eukaryotic RNA polymerase II causing transcription arrest affecting mainly metabolically highly active cells like hepatocytes and renal cells. The clinically most characteristic symptom is a 6-40 h lag phase before onset of gastrointestinal symptoms and the rapid progression of acute liver failure leading to multi-organ failure and death within a week if left untreated...
September 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27394132/comparison-of-two-different-modes-of-molecular-adsorbent-recycling-systems-for-liver-dialysis
#15
Euan Soo, Anja Sanders, Karlheinz Heckert, Tobias Vinke, Franz Schaefer, Claus Peter Schmitt
BACKGROUND: In children acute liver failure is a rare but life-threatening condition from which two-thirds do not recover with supportive therapy. Treatment is limited by the availability of liver transplants. Molecular adsorbent recirculating system (MARS) dialysis is a bridge to transplantation that enhances the chances of survival during the waiting period for a transplant, although it cannot improve survival. Open albumin dialysis (OPAL) is a new mode of albumin dialysis developed to further improve dialysis efficiency...
November 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27391228/low-protein-diets-in-patients-with-chronic-kidney-disease-a-bridge-between-mainstream-and-complementary-alternative-medicines
#16
REVIEW
Giorgina Barbara Piccoli, Irene Capizzi, Federica Neve Vigotti, Filomena Leone, Claudia D'Alessandro, Domenica Giuffrida, Marta Nazha, Simona Roggero, Nicoletta Colombi, Giuseppe Mauro, Natascia Castelluccia, Adamasco Cupisti, Paolo Avagnina
Dietary therapy represents an important tool in the management of chronic kidney disease (CKD), mainly through a balanced reduction of protein intake aimed at giving the remnant nephrons in damaged kidneys a "functional rest". While dialysis, transplantation, and pharmacological therapies are usually seen as "high tech" medicine, non pharmacological interventions, including diets, are frequently considered lifestyle-complementary treatments. Diet is one of the oldest CKD treatments, and it is usually considered a part of "mainstream" management...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/27374391/-italian-registry-dialysis-and-transplant-2011-2013
#17
Maurizio Nordio, Aurelio Limido, Ferruccio Conte, Anteo Di Napoli, Giuseppe Quintaliani, Gianpaolo Reboldi, Vito Sparacino, Maurizio Postorino
UNLABELLED: The Italian Registry of Dialysis and Transplantation (RIDT) has recently resumed the collection of data of patients on RRT in Italy. Data were requested to Regional Registries for the years 2011-2013 and they contributed according to their possibilities. Eighteen Regions or autonomous Provinces provided data with various degrees of completeness and this made possible to bridge the gap between the current and the previous census (referring to 2010). RESULTS: Incidencedata were associated to a sample with a coverage of 77% of the national population (46/60 million inhabitants)...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27085338/a-prospective-multicenter-survey-on-the-validity-of-shorter-periendoscopic-cessation-of-antithrombotic-agents-in-japan
#18
Katsuhiro Mabe, Mototsugu Kato, Koji Oba, Soichi Nakagawa, Hideyuki Seki, Shinichi Katsuki, Kentaro Yamashita, Shoko Ono, Yuichi Shimizu, Naoya Sakamoto
BACKGROUND: The management of antithrombotic agents for endoscopic procedures has recently focused on preventing periprocedural thrombosis in Western countries. However, this focus on shorter cessation of antithrombotic agents needs to be examined for its implications for post-procedural bleeding, with potential risk factors for such bleeding clarified in real-world clinical settings in Japan. METHODS: A Sapporo consensus group convened and developed a consensus document on the criteria for cessation of antithrombotic agents...
January 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27011425/update-on-insertion-and-complications-of-central-venous-catheters-for-hemodialysis
#19
REVIEW
Peter R Bream
Central venous catheters are a popular choice for the initiation of hemodialysis or for bridging between different types of access. Despite this, they have many drawbacks including a high morbidity from thrombosis and infection. Advances in technology have allowed placement of these lines relatively safely, and national guidelines have been established to help prevent complications. There is an established algorithm for location and technique for placement that minimizes harm to the patient; however, there are significant short- and long-term complications that proceduralists who place catheters should be able to recognize and manage...
March 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/26923611/flexible-single-layer-ionic-organic-inorganic-frameworks-towards-precise-nano-size-separation
#20
Liang Yue, Shan Wang, Ding Zhou, Hao Zhang, Bao Li, Lixin Wu
Consecutive two-dimensional frameworks comprised of molecular or cluster building blocks in large area represent ideal candidates for membranes sieving molecules and nano-objects, but challenges still remain in methodology and practical preparation. Here we exploit a new strategy to build soft single-layer ionic organic-inorganic frameworks via electrostatic interaction without preferential binding direction in water. Upon consideration of steric effect and additional interaction, polyanionic clusters as connection nodes and cationic pseudorotaxanes acting as bridging monomers connect with each other to form a single-layer ionic self-assembled framework with 1...
2016: Nature Communications
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