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Hemodialysis vascular access failure

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https://www.readbyqxmd.com/read/28297070/elbow-avf-configurations-and-indications
#1
Selcuk Baktiroglu, Fatih Yanar, Sercan Yuksel, Burak Celik, Halime G Kilic
INTRODUCTION: Brescia-Cimino radiocephalic arteriovenous fistula (AVF) remains the first-choice vascular access procedure for patients in need of long-term hemodialysis. The average life expectancy of patients receiving hemodialysis has increased in recent years and many patients now live longer and require secondary or tertiary procedures. Elbow fistulas should only rarely be constructed as primary fistulas. The aim of the surgeon must be not only to achieve a functioning fistula, but to avoid possible complications other than failure to mature (FTM), like distal ischemia and cardiac failure and to save the vessels as much as possible for future procedures...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297061/bioengineered-hemodialysis-access-grafts
#2
Shawn M Gage, Jeffrey H Lawson
There is a need for bioengineered therapies to improve the overall health of the growing and aging world population. Patients with renal failure have a life-long requirement for a durable form of hemodialysis vascular access. In this article, we review the history of tissue engineering as it pertains to bioengineered grafts and vessels for hemodialysis access. Over the years, various strategies have been utilized to develop ideal, humanized vessels for vascular replacement such as fixation of animal or human vessels, cell seeding of synthetic materials, and the synthesis of completely autologous or allogeneic bioengineered vessels...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297053/general-regional-or-local-anesthesia-for-successful-radial-cephalic-arteriovenous-fistula
#3
David Shemesh, Yefim Raikhinstein, Ilya Goldin, Oded Olsha
Autogenous fistulas and in particular radiocephalic fistulas are recommended as the first vascular access for hemodialysis. Unfortunately, the rates of early failure and non-maturation are very high. For more than a decade, brachial plexus block has been proposed as the anesthesia of choice for fistula creation due to its beneficial sympathectomy-like effect, causing vasodilation and attenuation of spasm. Until recently, there was not a single randomized clinical study supporting this proposition. Because performing regional anesthesia is time-consuming and requires expertise, many surgeons prefer local or general anesthesia for vascular access surgery...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297046/is-shear-stress-the-key-factor-for-avf-maturation
#4
Andrea Remuzzi, Michela Bozzetto, Paolo Brambilla
Autologous arteriovenous fistula (AVF) is the preferred choice for providing vascular access to hemodialysis (HD) patients, but it is still affected by high incidence of non-maturation or early failure. After creation, AVF must undergo vascular remodeling, a process characterized by an increase in blood vessel diameter and wall thickness, to allow efficient and adequate HD. A growing body of evidence indicates that AVF maturation is related to the response of endothelial cells (ECs) to changes in wall shear stress (WSS), and in particular, to changes of its peak value...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297045/surgical-technique-determines-the-outcome-of-the-brescia-cimino-avf
#5
Surendra Shenoy
Over the past 50 years, since Dr. Appel performed the first internal vascular access procedure for hemodialysis, the distal radiocephalic arteriovenous fistula continues to be the access of choice. Over time, failure to maturation has evolved as a major problem associated with this procedure depriving its benefits to many patients with end-stage renal disease. A variable incidence of this problem within similar patients suggests that surgical technique may play an important role in the development of non-maturation...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28288599/clinical-use-of-computational-modeling-for-surgical-planning-of-arteriovenous-fistula-for-hemodialysis
#6
Michela Bozzetto, Stefano Rota, Valentina Vigo, Francesco Casucci, Carlo Lomonte, Walter Morale, Massimo Senatore, Luigi Tazza, Massimo Lodi, Giuseppe Remuzzi, Andrea Remuzzi
BACKGROUND: Autogenous arteriovenous fistula (AVF) is the best vascular access (VA) for hemodialysis, but its creation is still a critical procedure. Physical examination, vascular mapping and doppler ultrasound (DUS) evaluation are recommended for AVF planning, but they can not provide direct indication on AVF outcome. We recently developed and validated in a clinical trial a patient-specific computational model to predict pre-operatively the blood flow volume (BFV) in AVF for different surgical configuration on the basis of demographic, clinical and DUS data...
March 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28249028/heart-rate-variability-during-hemodialysis-is-an-indicator-for-long-term-vascular-access-survival-in-uremic-patients
#7
Ya-Ting Huang, Yu-Ming Chang, I-Ling Chen, Chuan-Lan Yang, Show-Chin Leu, Hung-Li Su, Jsun-Liang Kao, Shih-Ching Tsai, Rong-Na Jhen, Woung-Ru Tang, Chih-Chung Shiao
BACKGROUND: Vascular access (VA) is the lifeline of hemodialysis patients. Although the autonomic nervous system might be associated with VA failure (VAF), it has never been addressed in previous studies. This study aimed to evaluate the predictive values of the heart rate variability (HRV) indices for long-term VA outcomes. METHODS: This retrospective study was conducted using a prospectively established cohort enrolling 175 adult chronic hemodialysis patients (100 women, mean age 65...
2017: PloS One
https://www.readbyqxmd.com/read/28238919/characteristics-management-and-outcomes-of-surgically-treated-arteriovenous-fistula-aneurysm-in-patients-on-regular-hemodialysis
#8
Hassan Al-Thani, Ayman El-Menyar, Noora Al-Thani, Mohammad Asim, Ahmed Hussein, Ahmed Sadek, Ahmed Sharaf, Amr Fares
BACKGROUND: To investigate the clinical characteristics, surgical interventions and outcomes of arteriovenous fistula (AVF) aneurysms, we retrospectively analyzed patients on regular hemodialysis (HD). METHODS: We conducted a cohort study of all patients with HD access who presented with AVF aneurysms and underwent operative procedures over a 11-year period. Patients' demographics, comorbidities, vascular access characteristics, management of aneurysms, complications and outcomes were analyzed...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28236920/bovine-carotid-artery-biologic-graft-outperforms-expanded-polytetrafluoroethylene-for-hemodialysis-access
#9
Isibor Arhuidese, Thomas Reifsnyder, Tasnim Islam, Omar Karim, Besma Nejim, Tammam Obeid, Umair Qazi, Mahmoud Malas
OBJECTIVE: Arteriovenous grafts remain reliable substitutes for permanent hemodialysis access in patients without a suitable autogenous conduit. Advances in conduit design and endovascular management of access-related complications question the preference for synthetic conduits over biologic grafts in contemporary practice. In this study, we compared outcomes between a bovine carotid artery (BCA) biologic graft and expanded polytetrafluoroethylene (ePTFE) grafts for hemodialysis access in a recent cohort of patients...
March 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
#10
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/28218361/arteriovenous-fistula-maturation-in-patients-with-permanent-access-created-prior-to-or-after-hemodialysis-initiation
#11
Juan C Duque, Laisel Martinez, Marwan Tabbara, Denise Dvorquez, Sushil K Mehandru, Arif Asif, Roberto I Vazquez-Padron, Loay H Salman
INTRODUCTION: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28183219/cilostazol-may-improve-maturation-rates-and-durability-of-vascular-access-for-hemodialysis
#12
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/28135701/catheter-failure-and-mortality-in-hemodialysis-patients-with-tunneled-cuffed-venous-catheters-in-a-single-center
#13
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
#14
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
#15
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/28110327/mortality-after-renal-allograft-failure-and-return-to-dialysis
#16
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/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#17
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28095482/an-increase-in-mean-platelet-volume-platelet-count-ratio-is-associated-with-vascular-access-failure-in-hemodialysis-patients
#18
Dong Ho Shin, So Yon Rhee, Hee Jung Jeon, Ji-Young Park, Shin-Wook Kang, Jieun Oh
After stenosis of arteriovenous vascular access in hemodialysis patients, platelets play a crucial role in subsequent thrombus formation, leading to access failure. In a previous study, the mean platelet volume (MPV)/platelet count ratio, but not MPV alone, was shown to be an independent predictor of 4-year mortality after myocardial infarction. However, little is known about the potential influence of MPV/platelet count ratio on vascular access patency in hemodialysis patients. A total of 143 patients undergoing routine hemodialysis were recruited between January 2013 and February 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28064472/arteriovenous-grafts-much-maligned-but-in-need-of-reconsideration
#19
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...
March 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#20
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
February 1, 2017: JAMA Internal Medicine
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