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Hemodialysis vascular access failure

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https://www.readbyqxmd.com/read/29429750/arteriovenous-fistula-maturation-in-prevalent-hemodialysis-patients-in-the-united-states-a%C3%A2-national%C3%A2-study
#1
Kenneth J Woodside, Sarah Bell, Purna Mukhopadhyay, Kaitlyn J Repeck, Ian T Robinson, Ashley R Eckard, Sudipta Dasmunshi, Brett W Plattner, Jeffrey Pearson, Douglas E Schaubel, Ronald L Pisoni, Rajiv Saran
BACKGROUND: Arteriovenous fistulas (AVFs) are the preferred form of hemodialysis vascular access, but maturation failures occur frequently, often resulting in prolonged catheter use. We sought to characterize AVF maturation in a national sample of prevalent hemodialysis patients in the United States. STUDY DESIGN: Nonconcurrent observational cohort study. SETTING & PARTICIPANTS: Prevalent hemodialysis patients having had at least 1 new AVF placed during 2013, as identified using Medicare claims data in the US Renal Data System...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29424185/predictors-of-early-failure-and-secondary-patency-in-native-arteriovenous-fistulas-for-hemodialysis
#2
Rui Abreu, Sara Rioja, Joaquin Vallespin, Xavier Vinuesa, Ruben Iglesias, Jose Ibeas
BACKGROUND: Native arteriovenous fistula (AVF) is considered the gold standard of vascular access for hemodialysis due to its longer survival, fewer complications, lower mortality and costs. Patency is important for effective dialysis treatment and this remains a challenge in nephrology. There are no well-defined prognostic factors for early and long-term AVF survival. The aim of this study was to evaluate comorbidity, analytical and ultrasound (US) variables as prognostic factors for early failure and AVF patency...
February 8, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29366423/therapeutic-approach-to-patients-with-heart-failure-with-reduced-ejection-fraction-and-end-stage-renal-disease
#3
Chakradhari Inampudi, Paulino Alvarez, Rabea Asleh, Alexandros Briasoulis
Several risk factors including Ischemic heart disease, uncontrolled hypertension, high output heart failure (HF) from shunting through vascular hemodialysis access, and anemia, contribute to development of HF in patients with end-stage renal disease (ESRD). Guideline-directed medical and device therapy for Heart Failure with Reduced Ejection Fraction (HFrEF) has not been extensively studied and may have limited safety and efficacy in patients with ESRD. Maintenance of interdialytic and intradialytic euvolemia is a key component of HF management in these patients but often difficult to achieve...
January 23, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29285424/maturation-of-arteriovenous-fistula-analysis-of-key-factors
#4
REVIEW
Muhammad A Siddiqui, Suhel Ashraff, Thomas Carline
The growing proportion of individuals suffering from chronic kidney disease has considerable repercussions for both kidney specialists and primary care. Progressive and permanent renal failure is most frequently treated with hemodialysis. The efficiency of hemodialysis treatment relies on the functional status of vascular access. Determining the type of vascular access has prime significance for maximizing successful maturation of a fistula and avoiding surgical revision. Despite the frequency of arteriovenous fistula procedures, there are no consistent criteria applied before creation of arteriovenous fistulae...
December 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#5
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
December 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29210164/relative-risk-of-home-hemodialysis-attrition-in-patients-using-a-telehealth-platform
#6
Eric D Weinhandl, Allan J Collins
INTRODUCTION: Home hemodialysis (HHD) facilitates increased treatment frequency, which may improve patient outcomes. However, attrition due to technique failure limits the clinical effectiveness of the modality. Nx2me Connected Health is a telehealth platform that enables ongoing assessment of HHD patients using NxStage equipment, and that may reduce patient burden. We aimed to assess whether use of Nx2me was associated with risk of HHD attrition. METHODS: We compared risks of all-cause attrition, dialysis cessation (i...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29188313/arteriovenous-fistula-maturation-failure-in-a-large-cohort-of-hemodialysis-patients-in-the-netherlands
#7
Bram M Voorzaat, Koen E A van der Bogt, Cynthia J Janmaat, Jan van Schaik, Friedo W Dekker, Joris I Rotmans
OBJECTIVES: Radiocephalic arteriovenous fistulas (RCAVF) are the preferred vascular access (VA) for hemodialysis (HD). Cohort studies from North America revealed that nonmaturation is a significant disadvantage of RCAVFs compared to other VAs. DESIGN: This present retrospective study describes the incidence of nonmaturation of AVFs and functional failure of arteriovenous grafts (AVG) in a multicentre cohort in the Netherlands and attempts to create a prediction model for nonmaturation of RCAVFs...
November 29, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29178510/the-pathogenesis-of-hemodialysis-vascular-access-failure-and-systemic-therapies-for-its-prevention-optimism-unfulfilled
#8
REVIEW
Andrea K Viecelli, Trevor A Mori, Prabir Roy-Chaudhury, Kevan R Polkinghorne, Carmel M Hawley, David W Johnson, Elaine M Pascoe, Ashley B Irish
In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are essential. Inadequate vascular remodeling and neointimal hyperplasia resulting in stenosis and frequently thrombosis are critical to the pathogenesis of access failure. Systemic medical therapies with pleiotropic effects including antiplatelet agents, omega-3 polyunsaturated fatty acids (fish oils), statins, and inhibitors of the renin-angiotensin-aldosterone system (RAAS) may reduce vascular access failure by promoting vascular access maturation and reducing stenosis and thrombosis through antiproliferative, antiaggregatory, anti-inflammatory and vasodilatory effects...
November 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#9
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29104939/asymmetric-dimethylarginine-does-not-predict-early-access-events-in-hemodialysis-patients-with-brachiocephalic-fistula-access
#10
Mary Hammes, Rita McGill, Promila Dhar, Rama S Madhurapantula
Background: Vascular access for hemodialysis is best provided by an arteriovenous fistula (AVF). AVF fail primarily because of neointimal hyperplasia. Asymmetric dimethlyarginine (ADMA) is a naturally occurring analogue of L-arginine, which is elevated in renal failure and impairs endothelial cell function. ADMA inhibits nitric oxide synthetase, leading to impaired nitric oxide production and contributing to the development of neointimal hyperplasia. ADMA was measured at the time of AVF placement to evaluate associations with access failure...
August 2017: International Journal of Nephrology and Kidney Failure
https://www.readbyqxmd.com/read/29080304/high-resolution-computational-fluid-dynamic-simulation-of-haemodialysis-cannulation-in-a-patient-specific-arteriovenous-fistula
#11
David Fulker, Bogdan Ene-Iordache, Tracie Barber
Arteriovenous fistulae (AVF) are the preferred choice of vascular access in hemodialysis patients; however, complications such as stenosis can lead to access failure or recirculation, which reduces dialysis efficiency. This study utilized computational fluid dynamics on a patient-specific radiocephalic fistula under hemodialysis treatment to determine the dynamics of access recirculation and identify the presence of disturbed flow. Metrics of transverse wall shear stress (transWSS) and oscillatory shear index (OSI) were used to characterize the disturbed flow acting on the blood vessel wall, while a power spectral density (PSD) analysis was used to calculate the any turbulence within the access...
March 1, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29076517/association-between-post-dialysis-hemoglobin-level-and-the-survival-of-vascular-access
#12
Hiroki Nishiwaki, Takeshi Hasegawa, Tatsuyoshi Ikenoue, Naoto Tominaga, Masahiko Yazawa, Hiroo Kawarazaki, Yugo Shibagaki, Yosuke Yamamoto, Shingo Fukuma, Shin Yamazaki, Shunichi Fukuhara
INTRODUCTION: Although a few dialysis facilities conduct a complete blood cell count for some patients at post-dialysis, including hemoglobin, clinical findings supporting the interpretation of results are scarce. The aim of this study was to investigate the association between post-dialysis hemoglobin level and vascular access failure with clinical data. METHODS: Study design: Case crossover design. Setting: Japanese dialysis facilities, which routinely take post-dialysis blood samples, including complete blood cell counts at least once a month...
October 24, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29027182/preoperative-management-of-arteriovenous-fistula-avf-for-hemodialysis
#13
Gaetano Alfano, Francesco Fontana, Mario Iannaccone, Patrizia Noussan, Gianni Cappelli
Native arteriovenous fistula (AVF) is the favorite access for hemodialysis (HD). The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recommends its creation in most patients with renal failure. Unfortunately, intensive efforts to promote native AVF in patients with marginal vessels have increased the rate of primary fistula failure. A non-functioning fistula prompts the use of central venous catheter (CVC) that, unlike AVF, has been associated with an increased risk of morbidity and mortality among patients receiving HD...
November 17, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29016441/epidemiology-and-outcomes-of-infectious-spondylodiscitis-in-hemodialysis-patients
#14
Yueh-An Lu, Wei-Chiao Sun, George Kuo, Chao-Yu Chen, Huang-Kai Kao, YuJr Lin, Chia-Hui Lee, Cheng-Chieh Hung, Ya-Chung Tian, Yu-Shien Ko, Hsiang-Hao Hsu
STUDY DESIGN: A retrospective study of patients who were hospitalized for infectious spondylodiscitis over a 13 year period. OBJECTIVE: To elucidate the epidemiology and prognostic factors of infectious spondylodiscitis in hemodialysis (HD) patients and to identify the impact of HD on infectious spondylodiscitis. SUMMARY OF BACKGROUND DATA: Only a few case studies of infectious spondylodiscitis in HD patients can be found in the literature...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28990213/the-complex-relationship-among-arteriovenous-access-heart-and-circulation
#15
EDITORIAL
Carlo Basile, Carlo Lomonte
There are currently near 400 000 patients on hemodialysis in the United States. More than 50% of those treated by chronic hemodialysis die because of a cardiovascular (CV) event. The majority of these patients have functional arteriovenous fistulas (AVFs). AVFs have an adverse effect on cardiac function, but their exact contribution to CV morbidity is not clear. It has long been known that a vascular access with an inappropriately high-flow rate may cause high-output heart failure. Paradoxically, there may be hemodynamic and cardiopulmonary benefits conferred by AVF particularly in severe chronic obstructive pulmonary disease...
January 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#16
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. METHODS: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28868755/matrix-metalloproteinase-2-predicts-arteriovenous-fistula-failure-in-hemodialysis-patients
#17
Dacian Călin Tirinescu, Ciprian Tomuleasa, Laura Pop, Cosmina Ioana Bondor, Dan Ştefan Vlăduţiu, Ioan Mihai Paţiu, Crina Claudia Rusu, Diana Tania Moldovan, Alina Potra, Ina Maria Kacsó
In hemodialysis patients the principal cause of arteriovenous fistula dysfunction is stenosis. Matrix-metalloproteinase-2 is implicated in the pathophysiological mechanism of stenosis development. Our study tried to assess the clinical impact of this protease on arteriovenous fistula survival. Seventy-nine prevalent dialysis patients with functional arteriovenous fistulas were included in the study. The presence of stenosis and the serum levels of matrix-metalloproteinase-2 were determined at the beginning of the study...
September 3, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28860634/deficiency-of-tlr4-homologue-rp105-aggravates-outward-remodeling-in-a-murine-model-of-arteriovenous-fistula-failure
#18
Taisiya Bezhaeva, ChunYu Wong, Margreet R de Vries, Eric P van der Veer, Carla M A van Alem, Ivo Que, Reshma A Lalai, Anton-Jan van Zonneveld, Joris I Rotmans, Paul H A Quax
Arteriovenous access dysfunction is a major cause of morbidity for hemodialysis patients. The pathophysiology of arteriovenous fistula (AVF) maturation failure is associated with inflammation, impaired outward remodeling (OR) and intimal hyperplasia. RP105 is a critical physiologic regulator of TLR4 signaling in numerous cell types. In the present study, we investigated the impact of RP105 on AVF maturation, and defined cell-specific effects of RP105 on macrophages and vascular smooth muscle cells (VSMCs). Overall, RP105(-/-) mice displayed a 26% decrease in venous OR...
August 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28844317/short-daily-nocturnal-and-conventional-home-hemodialysis-have-similar-patient-and-treatment-survival
#19
Karthik K Tennankore, Yingbo Na, Ron Wald, Christopher T Chan, Jeffrey Perl
Home hemodialysis (HHD) has many benefits, but less is known about relative outcomes when comparing different home-based hemodialysis modalities. Here, we compare patient and treatment survival for patients receiving short daily HHD (2-3 hours/5 plus sessions per week), nocturnal HHD (6-8 hours/5 plus sessions per week) and conventional HHD (3-6 hours/2-4 sessions per week). A nationally representative cohort of Canadian HHD patients from 1996-2012 was studied. The primary outcome was death or treatment failure (defined as a permanent return to in-center hemodialysis or peritoneal dialysis) using an intention to treat analysis and death-censored treatment failure as a secondary outcome...
August 23, 2017: Kidney International
https://www.readbyqxmd.com/read/28843984/arteriovenous-fistulae-for-haemodialysis-a-systematic-review-and-meta-analysis-of-efficacy-and-safety-outcomes
#20
REVIEW
L C Bylsma, S M Gage, H Reichert, S L M Dahl, J H Lawson
BACKGROUND: Arteriovenous fistulae are the currently recommended gold standard vascular access modality for haemodialysis because of their prolonged patency, improved durability, and low risk of infection for those that mature. However, notable disadvantages are observed in terms of protracted maturation time, associated high rates of catheter use, and substantial abandonment rates. The aim of this study was to quantitatively summarize the outcomes of fistula patency, infection, maturation, and abandonment published in the scientific literature...
October 2017: European Journal of Vascular and Endovascular Surgery
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