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https://www.readbyqxmd.com/read/28647632/axillary-artery-to-right-atrial-graft-for-dialysis-access-using-an-autologous-femoropopliteal-vein
#1
Yusuf Chauhan, M Mujeeb Zubair, Sashi Inkollu, Eric K Peden
Patients with prolonged history of central venous catheters can develop central venous occlusion. We report the creation of an axillary artery to right atrial graft using the femoropopliteal vein for dialysis access in a patient with end stage renal disease (ESRD) on hemodialysis with history of central venous occlusion. The patient had previously developed steal syndrome following a right brachial artery to right atrial polytetrafluoroethylene (PTFE) graft requiring revision to a left axillary artery inflow which subsequently thrombosed...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28642998/plastic-bronchitis-a-rare-complication-of-long-term-haemodialysis-catheter-placement-in-a-child
#2
Simon Carter, Dayna van de Hoef, Michael Temple, Elizabeth Harvey, Suhail Al-Saleh, Christoph Licht, Damien Noone
BACKGROUND: Despite peritoneal dialysis being the preferred mode of renal replacement therapy in neonates and infants, long-term haemodialysis may be necessary in a minority of patients with its attendant risks. CASE DIAGNOSIS/TREATMENT: This case identifies plastic bronchitis as a rare yet serious complication of long-term large bore vascular access when a vessel-sparing approach is not possible. CONCLUSIONS: An appropriately sized catheter should be used for the dialytic therapy required and to optimize access survival...
June 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28639916/benefits-of-long-versus-short-thrombolysis-times-for-acutely-thrombosed-hemodialysis-native-fistulas
#3
Susanne Regus, Werner Lang, Marco Heinz, Michael Uder, Axel Schmid
INTRODUCTION: Local thrombolysis with a time of exposure to recombinant tissue plasminogen activator of 15 to 150 minutes is commonly used to declot acutely thrombosed hemodialysis fistulas. The duration of thrombolysis for the restoration of arteriovenous blood flow remains controversial. The aim of this study was to investigate the outcomes of long thrombolysis treatment (LTT, 3 hours or more) and short thrombolysis treatment (STT, less than 3 hours) in our institution. METHODS: We retrospectively analyzed 86 interventional declotting procedures (28 STT and 58 LTT) applied to 86 acutely thrombosed hemodialysis fistulas...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28638613/cuff-extrusion-in-peritoneal-dialysis-single-centre-experience-with-the-cuff-shaving-procedure-in-five-patients-over-a-4-year-period
#4
Jedrzej A Debowski, Cora Wærp, Stig A Kjellevold, Sadollah Abedini
Catheter-related infections in peritoneal dialysis (PD) remain a significant complication, and some patients with recurrent exit-site (ESI) and/or tunnel infections may experience external cuff extrusion. In these cases, cuff-shaving has been described as a possible course of treatment. During a 4-year period, there were 44 patients with PD at our department; all received double-cuffed Tenckhoff catheters. Six (13%) never started on PD. Five (13%) of the 38 active PD patients experienced cuff extrusion. Causes of end-stage renal disease (ESRD) were diabetic nephropathy (n = 1), toxic nephropathy (n = 1), hypertensive nephrosclerosis (n = 1), systemic disease (n = 1) and one with unknown cause...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28633184/peritoneal-dialysis-catheter-position-evaluated-by-ultrasound-can-it-replace-abdomen-x-ray-in-patients-presenting-catheter-misplacement
#5
Matthias Zeiler, Luca Zanoli, Rosalia Viviana Scarfia, Stefano Santarelli, Antonio Granata
Background Malfunction of the peritoneal dialysis catheter is frequently caused by dislocation. The diagnostic approach is classically based on abdomen X-ray together with detailed case history and physical examination. Despite being rarely applied in clinical practice to evaluate catheter misplacement, ultrasound is a noninvasive, radiation-free technique that is potentially useful also to explore reasons for catheter malfunction. Consequently, we aimed to evaluate the diagnostic accuracy of ultrasound to identify peritoneal catheter misplacement...
June 20, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28624422/endovascular-proximal-forearm-arteriovenous-fistula-for-hemodialysis-access-results-of-the-prospective-multicenter-novel-endovascular-access-trial-neat
#6
Charmaine E Lok, Dheeraj K Rajan, Jason Clement, Mercedeh Kiaii, Ravi Sidhu, Ken Thomson, George Buldo, Christine Dipchand, Louise Moist, Joanna Sasal
BACKGROUND: Hemodialysis arteriovenous fistulas (AVFs) are suboptimally used primarily due to problems with maturation, early thrombosis, and patient nonacceptance. An endovascular approach to fistula creation without open surgery offers another hemodialysis vascular access option. STUDY DESIGN: Prospective, single-arm, multicenter study (Novel Endovascular Access Trial [NEAT]). SETTINGS & PARTICIPANTS: Consecutive adult non-dialysis-dependent and dialysis-dependent patients referred for vascular access creation at 9 centers in Canada, Australia, and New Zealand...
June 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28623638/urokinase-containing-locking-solution-in-the-prevention-of-dialysis-catheter-dysfunction-a-double-blind-randomized-controlled-trial
#7
Florence Bonkain, Freya Van Hulle, Peter Janssens, Concetta Catalano, Mandelina Allamani, Jean-Claude Stolear, Dominique Vandervelde, Mark Libertalis, Serge Treille, Marie M Couttenye, Annemie Dhondt, Wim Van Biesen, Jean François Fils, Christian Tielemans, Karl M Wissing
INTRODUCTION: The prophylactic use of recombinant tissue plasminogen activator once weekly reduces the incidence rate of tunneled cuffed catheter (TCC) malfunction and bacteremia as compared to the exclusive use of heparin as locking solution. Restricting the use of prophylactic thrombolytic agents to patients with a history of thrombotic TCC malfunction could be more cost effective. We conduct a multicenter, double-blind, randomized controlled trial and test the hypothesis that weekly use of urokinase lock will reduce the incidence of thrombotic malfunction by 50% in prevalent hemodialysis patients with a history of thrombotic malfunction...
June 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28621637/surgical-techniques-and-procedures-for-kidney-transplant-recipients-with-severe-atherosclerosis
#8
Koji Nanmoku, Yoshihiko Watarai, Shunji Narumi, Norihiko Goto, Takayuki Yamamoto, Makoto Tsujita, Takahisa Hiramitsu, Akio Katayama, Takaaki Kobayashi, Kazuharu Uchida
OBJECTIVES: Atherosclerosis is becoming a more common problem for dialysis patients. Therefore, transplant surgeons are faced with the need to develop surgical techniques and procedures for severe atherosclerosis. This study aimed to clarify the clinical features, the usefulness of examinations, and operative procedures for kidney transplant recipients with the complication of severe atherosclerosis. MATERIALS AND METHODS: Among 220 kidney transplant candidates, 13 patients (severe atherosclerosis group) were predicted complications due to arterial calcification in the bilateral iliac arterial system using a computed tomographic scan...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28613035/total-laparoscopic-hysterectomy-for-endometrial-cancer-in-a-renal-transplantation-patient-receiving-peritoneal-dialysis-case-report-and-literature-review
#9
Mamoru Kakuda, Eiji Kobayashi, Yusuke Tanaka, Yutaka Ueda, Kiyoshi Yoshino, Tadashi Kimura
Improved surgical techniques and immunosuppressant medications for organ transplantation have resulted in a significant increase in the number of women undergoing renal transplantation. Peritoneal dialysis (PD), a common supportive therapy for chronic renal failure, is also used in cases of renal transplantation failure. Herein, we report the first case of a rare total conventional laparoscopic gynecologic hysterectomy performed for endometrial cancer in a patient undergoing life-supportive PD as a result of renal transplantation failure...
June 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28599902/cost-effectiveness-analysis-of-vascular-access-referral-policies-in-ckd
#10
Steven M Shechter, Talon Chandler, M Reza Skandari, Nadia Zalunardo
BACKGROUND: The optimal timing of vascular access referral for patients with chronic kidney disease who may need hemodialysis (HD) is a pressing question in nephrology. Current referral policies have not been rigorously compared with respect to costs and benefits and do not consider patient-specific factors such as age. STUDY DESIGN: Monte Carlo simulation model. SETTING & POPULATION: Patients with chronic kidney disease, referred to a multidisciplinary kidney clinic in a universal health care system...
June 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#11
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
June 8, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28590946/hospitalization-among-individuals-waitlisted-for-kidney-transplant
#12
Kira L Newman, Raymond J Lynch, Andrew B Adams, Rebecca Zhang, Stephen O Pastan, Rachel E Patzer
BACKGROUND: For patients waitlisted for a deceased-donor kidney, hospitalization is associated with a lower likelihood of transplantation and worse posttransplant outcomes. However, individual-, neighborhood-, and regional-level risk factors for hospitalization throughout the waitlist period and specific causes of hospitalization in this population are unknown. METHODS: We used United States Renal Data System Medicare-linked data on patients waitlisted between 2005 and 2013 with continuous enrollment in Medicare Parts A & B (n=53 810) to examine the association between annual hospitalization rate and a variety of demographic, clinical, and social factors...
June 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28583554/enterobacter-cloacae-related-necrotizing-fasciitis-after-peritoneal-dialysis-in-delayed-graft-function-a-case-report
#13
Y-M Choe, K-M Park, Y S Jeon, S G Cho, K C Hong, W Y Shin, J H Song
INTRODUCTION: Necrotizing fasciitis is an uncommon soft-tissue infection that involves the superficial fascia, subcutaneous fat, and deep fascia. Herein, we report the first case of Enterobacter cloacae-related necrotizing fasciitis after peritoneal dialysis in delayed graft function. CASE: A 58-year-old man, who was a hepatitis B-viral carrier and had atrial fibrillation, received cadaveric renal transplantation with peritoneal dialysis and encountered delayed graft function...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28579291/successful-use-of-partial-aneurysmectomy-and-repair-approach-for-managing-complications-of-arteriovenous-fistulas-and-grafts
#14
Shouwen Wang, Michele S Wang
OBJECTIVE: Arteriovenous fistulas and grafts may often be associated with localized complications related to aneurysms/pseudoaneurysms, buttonholes, or structural defects that require proper management to ensure continued access functionality for hemodialysis. Partial aneurysmectomy and repair (PAR) is a targeted surgical approach specifically designed for managing these complications. The basic concepts of PAR include resecting unhealthy or excessive tissue over an access, reconstructing the vascular access lumen using in situ vascular wall or tissue when possible, and closing overlying skin with healthy margins to promote reliable healing...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28578687/target-weight-achievement-and-ultrafiltration-rate-thresholds-potential-patient-implications
#15
Jennifer E Flythe, Magdalene M Assimon, Robert A Overman
BACKGROUND: Higher ultrafiltration (UF) rates and extracellular hypo- and hypervolemia are associated with adverse outcomes among maintenance hemodialysis patients. The Centers for Medicare and Medicaid Services recently considered UF rate and target weight achievement measures for ESRD Quality Incentive Program inclusion. The dual measures were intended to promote balance between too aggressive and too conservative fluid removal. The National Quality Forum endorsed the UF rate measure but not the target weight measure...
June 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28575884/predictors-of-clinical-outcomes-in-hemodialysis-patients-a-multicenter-observational-study
#16
Tayebeh Soleymanian, Hossein Niyazi, Shaghayegh Noorbakhsh Jafari Dehkordi, Shokoufeh Savaj, Hassan Argani, Iraj Najafi
INTRODUCTION: Cardiovascular and noncardiovascular mortality and morbidity rates of hemodialysis patients are high despite improvement in dialysis delivery. MATERIALS AND METHODS: Hemodialysis patients (n = 532) from 9 hemodialysis facilities were enrolled in this cohort study in September 2012. Causes of death, hospitalization, and hemodialysis exit were recorded during a 28-month follow-up period. A Cox proportional hazard model was used to predict death adjusting for case-mix variables, nutrition variables, bone mineral variables, Kt/V, vascular access, and Charlson comorbidities index...
May 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28571995/is-peritoneal-dialysis-feasible-after-laparotomy-in-children-a-case-control-series-to-compare-outcomes
#17
A Bouty, A Faure, L Shaw, J Ah Toy, E Dobremez, M O'Brien, Y Heloury
OBJECTIVES: Peritoneal dialysis (PD) is the modality of choice for children with end-stage renal disease (ESRD) awaiting renal transplant; however, this option is sometimes avoided for those with previous laparotomy. The goal of this study was to compare the outcomes of PD in patients with and without previous laparotomy. PATIENTS AND METHODS: Twenty-four patients who had been started on peritoneal dialysis were retrospectively analysed. Group LAP consisted of six patients with previous laparotomy, and Group NO-LAP of 18 controls with either retroperitoneal or no abdominal surgery...
May 12, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28546369/the-utility-of-sonographic-assessment-in-selecting-patients-for-percutaneous-insertion-of-peritoneal-dialysis-catheter
#18
Renuka Shanmugalingam, Angela Makris, Hicham Hassan, Yan Li, Imelda DeGuzman, Hareeshan Nandakoban, Ananthakrishnapuram Aravindan, Govind Narayanan, Jeffrey Wong
♦Background: Percutaneous insertion of peritoneal dialysis (PD) catheters by nephrologists is a safe and effective alternative to open surgical techniques. These patients are usually carefully selected due to anatomical considerations and medical comorbidities, with the current literature suggesting exclusion of patients with prior abdominal surgery. ♦ Method: We conducted a retrospective cohort study of pre-dialysis patients who attended a preprocedural clinic in a tertiary center over 6 years. Procedural complications and catheter survival were assessed...
May 25, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28535525/expanded-hemodialysis-a-new-therapy-for-a-new-class-of-membranes
#19
Claudio Ronco, Gaetano La Manna
A wide spectrum of molecules is retained in end-stage kidney disease, normally defined as uremic toxins. These solutes have different molecular weights and radii. Current dialysis membranes and techniques only remove solutes in the range of 50-15,000 Da, with limited or no capability to remove solutes in the middle to high molecular weight range (up to 50,000 Da). Improved removal has been obtained with high cut-off (HCO) membranes, with albumin loss representing a limitation to their practical application...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28531901/a-comparison-between-intermittent-peritoneal-dialysis-and-automatic-peritoneal-dialysis-on-urgent-peritoneal-dialysis
#20
Chang Wang, Xiao Fu, Yuan Yang, Jun Deng, Hong-Qing Zhang, Hong-Mei Deng, Jia Lu, Youming Peng, Hong Liu, Fu-You Liu, Yinghong Liu
BACKGROUND: Urgent-start dialysis is a major problem for incident dialysis population. Urgent start on hemodialysis is associated with an increased risk of infectious or mechanical complications, and its mortality is equal to or higher than that of urgent start on peritoneal dialysis (PD). However, compared to patients starting PD in a planned setting, those on urgent-started PD have an increased risk of mechanical complications and lower technique survival. METHODS: In this study, 101 adult incident dialysis patients (≥18 years old) who underwent Tenckhoff catheter implantation were enrolled...
2017: American Journal of Nephrology
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