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Hemodialysis vascular access failure

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https://www.readbyqxmd.com/read/29027182/preoperative-management-of-arteriovenous-fistula-avf-for-hemodialysis
#1
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...
October 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29016441/epidemiology-and-outcomes-of-infectious-spondylodiscitis-in-hemodialysis-patients
#2
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
#3
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...
October 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#4
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...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28868755/matrix-metalloproteinase-2-predicts-arteriovenous-fistula-failure-in-hemodialysis-patients
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28823140/pre-existing-arterial-pathologic-changes-affecting-arteriovenous-fistula-patency-and-cardiovascular-mortality-in-hemodialysis-patients
#9
REVIEW
Ja Young Lee, Young Ok Kim
The radiocephalic arteriovenous fistula (AVF) provides optimal vascular access for hemodialysis; it has a higher long-term patency rate and fewer complications than other vascular access methods. However, the AVF has a high primary failure rate. The presence of small-diameter vessels at anastomosis sites is an important risk factor for AVF failure. However, in a recent study, despite selecting an adequate artery and vein for creating an AVF by routine preoperative vascular mapping, AVF maturation and primary failure occurred...
September 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28822660/prospective-randomized-study-of-long-term-hemodialysis-catheter-removal-versus-guidewire-exchange-to-treat-catheter-related-bloodstream-infection
#10
Hossam M Saleh, Mohamed M Tawfik, Hesham Abouellail
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822538/smooth-muscle-nitric-oxide-responsiveness-and-clinical-maturation-of-hemodialysis-arteriovenous-fistulae
#11
Xiaoyong Tong, Xiuyun Hou, Christopher Wason, Tal Kopel, Richard A Cohen, Laura M Dember
The arteriovenous fistula is the preferred type of hemodialysis vascular access for patients with end-stage renal disease, but a high proportion of newly created fistulas fail to mature for use. Stenosis caused by neointimal hyperplasia often is present in fistulas with maturation failure, suggesting that local mechanisms controlling vascular smooth muscle cell (SMC) migration and proliferation are important contributors to maturation failure. SMCs cultured from explants of vein tissue obtained at the time of fistula creation from 19 patients with end-stage renal disease were studied to determine whether smooth muscle responsiveness to nitric oxide is associated with fistula maturation outcomes...
September 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28779782/future-research-directions-to-improve-fistula-maturation-and-reduce-access-failure
#12
REVIEW
Haidi Hu, Sandeep Patel, Jesse J Hanisch, Jeans M Santana, Takuya Hashimoto, Hualong Bai, Tambudzai Kudze, Trenton R Foster, Jianming Guo, Bogdan Yatsula, Janice Tsui, Alan Dardik
With the increasing prevalence of end-stage renal disease, there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis, but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes in the setting of uremia, systemic inflammation, oxidative stress, and pre-existent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis and development of neointimal hyperplasia that narrows the AVF lumen, typically near the fistula anastomosis...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28753408/contribution-of-monoamine-oxidases-to-vascular-oxidative-stress-in-patients-with-end-stage-renal-disease-requiring-hemodialysis
#13
Diana Utu, Stelian Pantea, Oana M Duicu, Danina M Muntean, Adrian Sturza
Arteriovenous fistula (AVF) is the 'life line' for patients with end-stage renal disease (ESRD) undergoing hemodialysis. AVF maturation failure is a poorly understood process, one of the contributors being endothelial dysfunction due to oxidative stress. Monoamine oxidases (MAOs) A and B were recently identified as novel sources of vascular oxidative stress. The aim of the present study was to assess the contribution of MAOs to the endothelial dysfunction in patients with ESDR with indication of hemodialysis...
July 28, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28752375/biological-and-physical-factors-involved-in-the-maturation-of-arteriovenous-fistula-for-hemodialysis
#14
Andrea Remuzzi, Michela Bozzetto
One of the most important limitations of hemodialysis (HD) treatment is the vascular access (VA) that is used to connect the patient's blood vessels to the extracorporeal circulation. The arteriovenous fistula (AVF) obtained with native vessels is the VA of choice for the low incidence of infections and the long-term patency, but it is affected by high incidence of non-maturation or primary failure. Before use for cannulation, AVF must undergo vascular remodeling, with progressive increase in vessel diameter, to accommodate the increase in blood flow...
July 27, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28664239/blood-flow-in-idealized-vascular-access-for-hemodialysis-a-review-of-computational-studies
#15
Bogdan Ene-Iordache, Andrea Remuzzi
Although our understanding of the failure mechanism of vascular access for hemodialysis has increased substantially, this knowledge has not translated into successful therapies. Despite advances in technology, it is recognized that vascular access is difficult to maintain, due to complications such as intimal hyperplasia. Computational studies have been used to estimate hemodynamic changes induced by vascular access creation. Due to the heterogeneity of patient-specific geometries, and difficulties with obtaining reliable models of access vessels, idealized models were often employed...
June 29, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28655387/hemodialysis-treatment-of-cardiorenal-syndrome
#16
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje
AIMS: We evaluated the impact of hemodialysis on mortality and hospital readmission in patients with cardiorenal syndrome. METHODS: All patients were NYHA IV functional class and underwent laboratory testing, echocardiography, and cardiac functional testing. Hemodialysis was indicated in patients with progressive decline of kidney function and consequent failure to titrate heart failure medication as well as in patients with hypervolemia that was resistant to conservative treatment with more than 4 annual hospitalizations due to heart failure and/or concomitant chronic kidney disease stage III - IV...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28649146/a-predictive-framework-to-elucidate-venous-stenosis-cfd-shape-optimization
#17
S M Javid Mahmoudzadeh Akherat, Kevin Cassel, Michael Boghosian, Mary Hammes, Fredric Coe
The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient's upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to excessive neointimal hyperplasia (NH) and subsequently stenosis. Development of a framework to monitor and predict the evolution of the venous system post access creation can greatly contribute to maintaining access patency...
July 1, 2017: Computer Methods in Applied Mechanics and Engineering
https://www.readbyqxmd.com/read/28625819/outcomes-of-relocation-of-basilic-vein-in-brachiobasilic-fistulas-in-chronic-renal-failure
#18
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/28603718/impact-of-sleep-apnea-on-in-hospital-outcomes-after-transcatheter-aortic-valve-replacement-insight-from-national-inpatient-sample-database-2011-2014
#19
Ilhwan Yeo, Hasan Ahmad, Wilbert S Aronow
BACKGROUND: Sleep apnea is associated with worse outcomes following various kinds of surgeries. There is a paucity of data on the association of sleep apnea with clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We used National Inpatient Sample (NIS) data 2011-2014 to identify patients undergoing TAVR. Association between sleep apnea and in-hospital postoperative outcomes were assessed by multivariate logistic regression and 1:1 propensity score matching analyses...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28581677/interplay-of-volume-blood-pressure-organ-ischemia-residual-renal-function-and-diet-certainties-and-uncertainties-with-dialytic-management
#20
REVIEW
Ercan Ok, Nathan W Levin, Gulay Asci, Charles Chazot, Huseyin Toz, Mehmet Ozkahya
Extracellular fluid volume overload and its inevitable consequence, hypertension, increases cardiovascular mortality in the long term by leading to left ventricular hypertrophy, heart failure, and ischemic heart disease in dialysis patients. Unlike antihypertensive medications, a strict volume control strategy provides optimal blood pressure control without need for antihypertensive drugs. However, utilization of this strategy has remained limited because of several factors, including the absence of a gold standard method to assess volume status, difficulties in reducing extracellular fluid volume, and safety concerns associated with reduction of extracellular volume...
September 2017: Seminars in Dialysis
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