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Dialysis vascular access

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https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#1
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27903996/survival-of-patients-on-hemodialysis-and-predictors-of-mortality-a-single-centre-analysis-of-time-dependent-factors
#2
Shahrzad Ossareh, Farhat Farrokhi, Marjan Zebarjadi
INTRODUCTION: This study aimed to evaluate the outcome and predictors of survival in hemodialysis patients of Hasheminejad Kidney Center where a comprehensive dialysis care program has been placed since 2004. MATERIALS AND METHODS: Data of 560 hemodialysis patients were used to evaluate 9-year survival rates and predictors of mortality. Cox regression models included comorbidities as well as averaged and 6-month-averaged time-dependent values of laboratory findings as independent factors...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27886362/balloon-assisted-venous-access-salvage-through-a-thrombosed-arteriovenous-graft
#3
Chen Pong Wong, Karthikeyan Damodharan, Thijs A J Urlings, Sivanathan Chandramohan
INTRODUCTION: Maintaining vascular access by means of radiological intervention has become the mainstay of management of patients with central venous stenoses and occlusions (CVO), which can be challenging. We present a case of balloon-assisted percutaneous puncture of an occluded left subclavian vein, through a thrombosed arteriovenous graft, for a tunneled dialysis catheter insertion. METHODS: A thrombosed left arm arteriovenous graft was accessed, and the occluded left subclavian vein was traversed with 0...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#4
C Petridis, M Nitschke, W Lehne, E Smith, J P Goltz, H Lehnert, M Meier
OBJECTIVE/BACKGROUND: Central venous tunnelled hemodialysis catheters (CVTC) are used for initial vascular access in patients with renal failure. Tip design of the CVTC may play an important role in catheter function and complication rates, influencing adequate hemodialysis treatment of these patients. METHODS: This prospective, observational cohort study compared the function and complication rates of two CVTCs in patients with end stage renal disease (ESRD) within a follow-up period of 24 months...
November 19, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#5
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27866375/pre-operative-assessment-for-arteriovenous-fistula-placement-for-dialysis
#6
REVIEW
Maria G Marques, Pedro Ponce
Native AV fistulas are considered to be the best VA for most dialysis patients. A careful preoperative process of care is essential to maximize the proportion of fistulas that achieve adequacy for dialysis. An individualized and timely evaluation of patients starts early with the identification of risk factors, followed by a physical examination which should be complemented by ultrasound vascular mapping in most cases. Vascular mapping includes any technique that leads to information on patient's inflow and outflow anatomy (± hemodynamics) as they relate to arteriovenous access creation and may predict maturation...
November 20, 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27865711/use-of-an-eptfe-covered-nitinol-self-expanding-stent-graft-for-the-treatment-off-pre-closure-device-failure-during-transcatheter-aortic-valve-replacement
#7
Arie Steinvil, Nelson Bernardo, Toby Rogers, Edward Koifman, Kyle Buchanan, M Chadi Alraies, Christian Shults, Rebecca Torguson, Petros G Okubagzi, Augusto D Pichard, Lowell F Satler, Itsik Ben-Dor, Ron Waksman
OBJECTIVES: Our aim was to describe our experience with the use of an ePTFE-covered nitinol self-expanding stent graft (GORE® VIABAHN® Endoprosthesis, Gore Medical, USA) placed in the common femoral artery for the treatment of suture-mediated pre-closure device failure following transcatheter aortic valve replacement (TAVR). BACKGROUND: Access site-related vascular complications (VC) following sheath removal related to pre-closure device failure during TAVR are common and treatment options may vary...
October 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27861462/at-which-stage-of-end-stage-kidney-disease-should-chronic-dialysis-be-started
#8
Gonzalo A Bravo-Soto, Trinidad Madrid
The number of patients requiring renal replacement therapy has increased exponentially in recent years. However, there is still controversy regarding the best moment to initiate chronic dialysis. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews comprising 21 trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded delaying the initiation of dialysis probably does not increase mortality risk in chronic kidney disease and makes little or no difference in the risk of requiring a temporary catheter or having to check the vascular access...
November 15, 2016: Medwave
https://www.readbyqxmd.com/read/27834451/elements-of-dialysis-nursing-practice-associated-with-successful-cannulation-result-of-an-international-survey
#9
Maria Teresa Parisotto, Francesco Pelliccia, Aileen Grassmann, Daniele Marcelli
BACKGROUND/AIM: Vascular access (VA) cannulation is an essential skill for dialysis nurses: failure to correctly repeat this operation daily may result in serious complications for the patients. This study investigates if different aspects of arteriovenous fistula and graft cannulation have an effect on the development of acute access complications, which may affect the VA survival. METHODS: In April 2009 a cross-sectional survey was conducted in 171 dialysis units located in Europe, the Middle East and Africa to collect details on VA cannulation practices...
November 9, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27832203/angiotensin-converting-enzyme-inhibitors-angiotensin-receptor-blockers-and-calcium-channel-blockers-are-associated-with-prolonged-vascular-access-patency-in-uremic-patients-undergoing-hemodialysis
#10
Fu-An Chen, Chih-Chiang Chien, Yu-Wei Chen, Yu-Te Wu, Chih-Ching Lin
BACKGROUND: Vascular access failure is a huge burden for patients undergoing hemodialysis. Many efforts have been made to maintain vascular access patency, including pharmacotherapy. Angiotensin converting enzyme inhibitor (ACE-I), angiotensin receptor blocker (ARB), and calcium channel blocker (CCB) are known for their antihypertensive and cardio-protective effects, however, their effects on long-term vascular access patency are still inconclusive. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We retrospectively enrolled patients commencing maintenance hemodialysis between January 1, 2000, and December 31, 2006 by using National Health Insurance Research Database in Taiwan...
2016: PloS One
https://www.readbyqxmd.com/read/27831511/diagnosis-treatment-and-prevention-of-hemodialysis-emergencies
#11
REVIEW
Manish Saha, Michael Allon
Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies...
November 9, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27824950/urgent-start-peritoneal-dialysis-and-hemodialysis-in-esrd-patients-complications-and-outcomes
#12
Haijiao Jin, Wei Fang, Mingli Zhu, Zanzhe Yu, Yan Fang, Hao Yan, Minfang Zhang, Qin Wang, Xiajing Che, Yuanyuan Xie, Jiaying Huang, Chunhua Hu, Haifen Zhang, Shan Mou, Zhaohui Ni
BACKGROUND: Several studies have suggested that urgent-start peritoneal dialysis (PD) is a feasible alternative to hemodialysis (HD) in patients with end-stage renal disease (ESRD), but the impact of the dialysis modality on outcome, especially on short-term complications, in urgent-start dialysis has not been directly evaluated. The aim of the current study was to compare the complications and outcomes of PD and HD in urgent-start dialysis ESRD patients. METHODS: In this retrospective study, ESRD patients who initiated dialysis urgently without a pre-established functional vascular access or PD catheter at a single center from January 2013 to December 2014 were included...
2016: PloS One
https://www.readbyqxmd.com/read/27819399/cytomegalovirus-encephalitis-in-a-hemodialysis-patient-a-rare-association
#13
Alberto Vera, Pablo Ruano, Esther Ortega, Borja Quiroga
Haemodialysis patients are at greater risk of infections than individuals not on dialysis due to their immunosuppressive state caused by several factors (uraemia, vascular access, inflammation, malnutrition). However, infections affecting the central nervous system are not frequent in this population. We present the case of a 77-year-old man with end-stage renal disease who was admitted to the emergency department for a decreased level of consciousness and fever. Although the initial clinical suspicion oriented to a urinary infection, the lack of improvement forced us to perform a lumbar puncture...
November 7, 2016: New Microbiologica
https://www.readbyqxmd.com/read/27791257/assessing-radiocephalic-wrist-arteriovenous-fistulas-of-obtuse-anastomosis-using-computational-fluid-dynamics-and-clinical-application
#14
Jinkee Lee, Sunho Kim, Sung-Min Kim, Ryungeun Song, Hyun Kyu Kim, Jang Sang Park, Sun Cheol Park
INTRODUCTION: A radiocephalic arteriovenous fistula (AVF) is the best choice for achieving vascular access (VA) for hemodialysis, but this AVF has high rates of early failure due to juxta-anastomotic stenosis, making it impossible to use for dialysis. Low hemodynamic shear stress contributes to the pathophysiology of VA failure due to secondary thrombosis, stenosis, and re-occlusion after percutaneous intervention. METHODS: We used a computational fluid dynamics (CFDs) approach to evaluate the shear stress distribution and minimize its effects under various conditions including changes in the anastomosis angle...
November 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#15
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
https://www.readbyqxmd.com/read/27772644/intensive-hemodialysis-and-potential-risks-with-increasing%C3%A2-treatment
#16
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27763477/temporal-variability-of-readmission-determinants-in-postoperative-vascular-surgery-patients
#17
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27743809/initial-clinical-experience-with-a-polytetrafluoroethylene-vascular-dialysis-graft-reinforced-with-nitinol-at-the-venous-end
#18
Filippo Benedetto, Domenico Spinelli, Narayana Pipitò, Giambattista Gagliardo, Alberto Noto, Simona Villari, Antonio David, Francesco Spinelli
OBJECTIVE: The purpose of this study was to examine the outcomes of a vascular hybrid polytetrafluoroethylene (PTFE) graft, provided with a nitinol-reinforced section (NRS) on one end, in hemodialysis vascular access placement. METHODS: A retrospective study was conducted including all the consecutive patients who underwent Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) implantation for hemodialysis access placement between October 2013 and November 2015...
October 12, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27692441/successful-hemodialysis-arteriovenous-fistula-creation-in%C3%A2-a%C3%A2-patient-with-continuous-flow-left-ventricular-assist-device%C3%A2-support
#19
Andrew I Chin, Kathleen Tong, John P McVicar
Heart failure necessitating left ventricular assist device (LVAD) support can lead to kidney failure requiring dialysis. Some of these patients may require long-term hemodialysis (HD). Optimal vascular access for a patient on long-term HD therapy with an LVAD remains a complex issue. The majority of LVADs are of the continuous-flow type, and it has been theorized that native arteriovenous fistula maturation may be impaired in a setting of decreased pulsatile arterial flow. We describe a case of successful creation and use of an arteriovenous fistula in an HD-dependent patient with a continuous-flow LVAD...
September 27, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27684071/arterio-venous-fistula-is-it-critical-for-prolonged-survival-in-the-over-80-s-starting-haemodialysis
#20
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
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