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https://www.readbyqxmd.com/read/29029967/-10-years-of-external-quality-assurance-in-dialysis-in-germany-results-and-future-prospects
#1
Dorothea Büchtemann, Stefan Meinhold, Peter Follert
BACKGROUND: In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme based on the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres...
October 10, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29026627/marked-peripheral-eosinophilia-due-to-prolonged-administration-of-posaconazole
#2
Maher Alharbi, Rae-Kiran Jhinger, Terence Wuerz, Andrew Walkty
Introduction. Posaconazole is a triazole antifungal that is used in the treatment of a variety of fungal infections, as well as in the management of mucormycosis (on an off-label basis). Eosinophilia associated with exposure to azole antifungals has been described rarely in the literature. Case presentation. A 31-year-old male on peritoneal dialysis (PD) for end-stage renal disease, secondary to diabetic nephropathy, presented to hospital with abdominal pain after a trip to St Lucia. He was taken to the operating room, where the PD catheter was removed and an abdominal-wall abscess was debrided...
June 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29017808/a-novel-technique-for-duplex-guided-office-based-interventions-for-patients-with-acute-arteriovenous-fistula-occlusion
#3
Afsha Aurshina, Enrico Ascher, Anil Hingorani, Natalie Marks
OBJECTIVE: The purpose of the study was to aggressively salvage acutely occluded arteriovenous fistulas (AVFs) using duplex imaging as the sole imaging modality for percutaneous transluminal angioplasty of acutely thrombosed AVF. METHODS: Over a period of 12 months, 14 patients with acute thrombosis of their AVFs underwent 18 procedures in a single center for AVF salvage. All 14 patients presented with chronic renal failure, and six were diabetic. All patients were treated under duplex guidance alone...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29017700/switching-temporary-hemodialysis-catheters-to-long-term-catheters-exchange-versus-de-novo-placement-any-difference-in-line-infection-%C3%A2
#4
Maen Aboul Hosn, Zeina Nasser, Elias Elias, Walid Medawar, Majida Daouk, Jamal Hoballah, Fady Haddad
BACKGROUND: Shifting from a short-term catheter to a long-term one is done either by removing the old catheter and placing a new long-term one via fresh new puncture site, or by replacing the old catheter with a long-term one over a guidewire. AIM: We aimed to describe our technique in changing a temporary line to a long-term catheter (LTC) over a guidewire and to determine the incidence of line-related infections following this procedure. MATERIALS AND METHODS: A retrospective pilot study was conducted between 2005 and 2010 at the American University of Beirut Hospital...
October 11, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29016441/epidemiology-and-outcomes-of-infectious-spondylodiscitis-in-hemodialysis-patients
#5
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/28992851/initiation-of-peritoneal-dialysis-in-the-first-weeks-after-catheter-insertion-a-comparison-of-a-neutral-ph-low-gdp-pd-fluid-and-a-conventional-pd-fluid%C3%A2
#6
Karima Farhat, Frans J van Ittersum, Pieter M Ter Wee, Nanne J Paauw, Robbert H J Beelen, Caroline E Douma
BACKGROUND: Chronic exposure to peritoneal dialysis (PD) fluid is associated with development of functional and structural alterations of the peritoneal membrane. The exact time point at which these changes actually occur is not known. Whether changes to the peritoneum occur immediately after installation of PD fluids and whether there is a difference between neutral-pH, low glucose degradation product (low-GDP) PD fluids and conventional PD fluids is not known either. MATERIALS AND METHODS: We performed an observational study...
October 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28988370/morphologic-characteristics-of-macroscopic-peritoneal-finding-in-patients-with-peritoneal-dialysis
#7
Chieko Hamada, Hirotaka Nakamoto, Yusuke Suzuki
Peritoneal dialysis (PD) has been an attractive treatment for end-stage kidney disease. Long-term exposure to the PD solution creates functional and morphological alterations, and these alterations diminish the efficacy of PD. It is important to establish an evaluation of the changes in PD patients and strategies for the prevention of PD damage and encapsulating peritoneal sclerosis (EPS). We determined the relationship between clinical findings and macroscopic morphological findings by laparoscopy in patients receiving PD...
October 7, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28983900/predicting-tissue-plasminogen-activator-use-and-success-in-in-center-hemodialysis-patients
#8
Sarah Daisy Kosa, Chenglin Ye, Lehana Thabane, Amiram Gafni, Charmaine E Lok
INTRODUCTION: Hemodialysis catheter malfunction is problematic. We aimed to determine clinical, catheter, and hemodialysis variables that predict: (i) catheter malfunction requiring recombinant tissue-plasminogen activator (TPA) treatment and (ii) the success of TPA administration. METHODS: Clinical, catheter, and hemodialysis variables were collected from a cohort of 559 catheters (141,526 catheter days) in 175 hemodialysis patients (2008-2011). Time to, and predictors of, catheter malfunction were determined for all catheters and primary catheters only, analyzed by Cox-proportional hazard model, multi-variable logistic regression model, and mixed-effect logistic regression models...
October 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28974524/risk-of-infective-endocarditis-in-patients-with-end-stage-kidney-disease
#9
Mavish S Chaudry, Nicholas Carlson, Gunnar H Gislason, Anne-Lise Kamper, Marianne Rix, Vance G Fowler, Christian Torp-Pedersen, Niels E Bruun
BACKGROUND AND OBJECTIVES: Endocarditis is a serious complication in patients treated with RRT. The study aimed to examine incidence and risk factors of endocarditis in patients with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Danish National Registry on Regular Dialysis and Transplantation contains data on all Danish patients receiving renal replacement (hemodialysis, peritoneal dialysis, or kidney transplantation) for ESRD. Incidence of endocarditis was estimated for each RRT modality...
October 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28970368/united-kingdom-catheter-study-protocol-synopsis
#10
Victoria Briggs, Ivonne Solis-Trapala, Allan Wailoo, Keith McCullough, Mark Lambie, Fergus J Caskey, James Fotheringham, Simon J Davies, Martin Wilkie
BACKGROUND: High-quality peritoneal dialysis (PD) catheter insertion pathways are essential for optimal access to the therapy. Dialysis outcomes are influenced by a range of patient and center-related factors, and there is a need to better understand these so that catheter insertion pathways can be better matched to individual circumstances. OBJECTIVES: To examine how patient- and center-related factors influence the choice of catheter insertion pathways for a PD patient, and the impact of such factors and pathways on patient outcomes, and specifically, to compare the occurrence of and recovery from PD catheter-related adverse events and mortality in individuals who had surgical catheter insertion with those who had medical catheter insertion, and evaluate health economics...
September 28, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28970365/early-peritonitis-and-its-outcome-in-incident-peritoneal-dialysis-patients
#11
Emily J See, David W Johnson, Carmel M Hawley, Elaine M Pascoe, Darsy Darssan, Philip A Clayton, Monique Borlace, Sunil V Badve, Kamal Sud, Neil C Boudville, Yeoungjee Cho
BACKGROUND: Early-onset peritonitis is a serious complication of peritoneal dialysis (PD) and is associated with heightened risks of technique failure and death. The risk factors for early peritonitis and its outcomes are unknown. METHODS: This registry study examined all incident Australian PD patients between 2003 and 2014. The primary outcome was early peritonitis, defined as onset within 12 months of starting therapy. Secondary outcomes were medical cure, relapse/recurrence, catheter removal, peritonitis-associated technique failure, and peritonitis-associated death...
September 28, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28968598/prognostic-factors-of-human-immunodeficiency-virus-infected-patients-on-chronic-hemodialysis
#12
Ivo Laranjinha, Patrícia João Matias, Jorge Dickson, Hermínia Estibeiro, Helena Boquinhas, José Diogo Barata
BACKGROUND/AIMS: The number of human immunodeficiency virus (HIV)-infected patients on hemodialysis (HD) have increased, and their prognostic factors are still poorly clarified. The study aimed to identify factors that can influence the survival of HIV-infected patients on HD. METHODS: We performed a retrospective cohort study of 44 HIV-infected patients on HD. RESULTS: A total of 17 patients (39%) died. Median survival on HD was 30.8 months and the survival rate at 1 and 5 years was 82...
October 3, 2017: Blood Purification
https://www.readbyqxmd.com/read/28958447/an-outbreak-of-bloodstream-infection-due-to-extensively-resistant-acinetobacter-baumannii-among-neonates
#13
Aysegul Ulu-Kilic, Aycan Gundogdu, Fatma Cevahir, Huseyin Kilic, Tamer Gunes, Emine Alp
BACKGROUND: Extensively resistant Acinetobacter baumannii has emerged and spread worldwide as a significant cause of health care-associated infections and outbreaks. It also causes life-threatening infections among neonates, including bacteremia. The aim of this study was to investigate an outbreak of A baumannii bacteremia (ABB) among neonates. MATERIALS AND METHODS: A retrospective, case-control study was conducted from July 2014 to July 2015 in a neonatal intensive care unit (NICU)...
September 25, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28950719/evaluation-of-thromboelastometry-in-sepsis-in-correlation-with-bleeding-during-invasive-procedures
#14
Pavel Lukas, Miroslav Durila, Jakub Jonas, Tomas Vymazal
Prolongation of prothrombin time (PT) is often encountered in patients with sepsis. On the other hand, thromboelastometry as a global coagulation test might yield normal results. The aim of our study was to evaluate whether prolonged PT in the presence of normal thromboelastometry parameters is associated with severe bleeding in patients with sepsis undergoing invasive procedures. In patients with sepsis undergoing low-risk bleeding invasive procedures (central venous catheter placement, dialysis catheter insertion, drain insertion, and so on) or high-risk bleeding invasive procedures (surgical tracheostomy, surgical laparotomy, thoracotomy, and so on), coagulation was assessed by thromboelastometry using EXTEM test (test for evaluation of the extrinsic pathway of coagulation, contains activator of extrinsic pathway) and with PT...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28937077/practice-pattern-of-hemodialysis-among-end-stage-renal-disease-patients-in-rural-south-india-a-single-center-experience
#15
R Hemachandar
Hemodialysis (HD) is the most common mode of renal replacement therapy for end-stage renal disease (ESRD) patients in India. However, the practice and pattern of dialysis in a hospital serving rural population is largely unknown. A prospective study of 127 ESRD patients initiated on HD between January 2013 and December 2014 was done. The study included 101 males and 26 females, with a mean age of 50.05 ± 13.80 years. Native kidney disease was unknown in 45.67% of patients as they presented very late in their disease course...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28937074/clinicoepidemiological-profile-of-peritonitis-complicating-acute-peritoneal-dialysis-a-single-center-experience
#16
Kunal Gandhi, Dharmendra Prasad, Vinay Malhotra, Dhananjai Agrawal, Pankaj Beniwal, Amith Vijay Leon Dsouza
A prospective observational study examining the incidence and microbiological aspects of peritonitis complicating acute intermittent peritoneal dialysis (IPD) was performed. A total of 145 acute IPD treatments were included involving 112 patients. The majority of patients suffered from acute kidney injury (72.3%) secondary to sepsis. Peritonitis occurred in 31 treatment sessions, giving a frequency of 21.4% of procedures performed. The mean interval between starting dialysis and the first sign of peritonitis was 2...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28931700/peritoneal-dialysis-for-the-treatment-of-cardiorenal-syndrome-type-1-a-prospective-brazilian-study
#17
Daniela Ponce, Cassiana Góes, Mariele Oliveira, Andre Balbi
This study aimed to explore the role of high-volume peritoneal dialysis (HVPD) in cardiorenal syndrome (CRS) type 1 patients in relation to metabolic and fluid control and outcome. Sixty-four patients were treated by HVPD (prescribed Kt/V = 0.50/session), flexible catheter and cycler. Mean age was 68.8 ± 15.4 years, 54.7% needed intravenous inotropic agents and/or intravenous vasodilators, 31.2% were on mechanical ventilation, acute coronary syndrome (ACS) was the main cause of acute disease heart failure (ADHF) 48...
September 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#18
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/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#19
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28917008/peritoneal-dialysis-catheter-function-and-survival-are-not-adversely-affected-by-obesity-regardless-of-the-operative-technique-used
#20
Monika A Krezalek, Nicolas Bonamici, Kristine Kuchta, Brittany Lapin, JoAnn Carbray, Woody Denham, John Linn, Michael Ujiki, Stephen P Haggerty
BACKGROUND: Obesity has been considered a relative contraindication to peritoneal dialysis (PD). Surprisingly, PD catheter dysfunction rates and longevity have not been studied in the growing obese ESRD population. The aim of this study was to determine the effect of patient weight on PD catheter survival in the three insertion technique categories of advanced laparoscopy (AL), basic laparoscopy (BL), and open. METHODS: We examine retrospectively collected data on 231 consecutive PD catheter insertions at the NorthShore University HealthSystem between 2004 and 2014...
September 15, 2017: Surgical Endoscopy
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