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Dialysis vascular access

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https://www.readbyqxmd.com/read/29914835/imbalance-of-coagulation-and-fibrinolysis-can-predict-vascular-access-failure-in-patients-on-hemodialysis-after-vascular-access-intervention
#1
Yukiko Hasuike, Naoto Kakita, Makoto Aichi, Satoko Masachika, Mari Kantou, Shoko Ikeda Takahashi, Masayoshi Nanami, Yasuyuki Nagasawa, Takahiro Kuragano, Takeshi Nakanishi
OBJECTIVE: For patients with end-stage renal disease on hemodialysis, the durability of vascular access (VA) is still far from optimal, and access survival after intervention for access failure is an important aspect. Procoagulant status is a leading cause of access failure. Coagulation-fibrinolysis imbalance can occur in hemodialyzed patients, but the influence of the imbalance has not been fully elucidated. METHODS: We prospectively examined coagulation-fibrinolysis balance to assess the risk of access failure after the intervention of revascularization in a cohort of 462 hemodialysis patients...
June 15, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29879718/acute-kidney-injury-before-dialysis-initiation-predicts-adverse-outcomes-in-hemodialysis-patients
#2
Timmy Lee, Silvi Shah, Anthony C Leonard, Pratik Parikh, Charuhas V Thakar
BACKGROUND: Acute kidney injury (AKI) is associated with increased morbidity and mortality. Mortality in end-stage renal disease (ESRD) patients is highest during the first year of dialysis. The impact of pre-ESRD AKI events on long-term outcomes in incident ESRD patients remains unknown. METHODS: We evaluated a retrospective cohort of 47,341 incident hemodialysis patients from the United States Renal Data System with linked Medicare data for at least 2 years prior to hemodialysis initiation...
June 7, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29875179/planning-vascular-access-in-peritoneal-dialysis-defining-high-risk-patients
#3
Hugo Ferreira, Ana T Nunes, Ana Oliveira, Ana Beco, Joana Santos, Manuel Pestana
BACKGROUND: Peritoneal dialysis (PD) is an effective renal replacement technique. However, every year a considerable number of patients are transferred to hemodialysis (HD). Our aim was to identify those at risk, in order to place an arteriovenous fistula (AVF). METHODS: Case-control study enrolling all prevalent patients in 2014 and 2015 in our clinic. Groups: 72 case patients who were transferred definitively to HD, 111 control patients (remaining on PD, transplanted, recovered renal function, or deceased)...
June 6, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29874975/subjective-global-assessment-dialysis-malnutrition-score-and-arteriovenous-fistula-outcome-a-comparison-with-charlson-comorbidity-index
#4
Leonardo Spatola, Silvia Finazzi, Albania Calvetta, Claudio Angelini, Salvatore Badalamenti
INTRODUCTION: Malnutrition is a well-recognized risk factor for all-cause mortality in hemodialysis patients. However, its role for arteriovenous fistulas outcome has not been exhaustively investigated. Our aim was to point out the impact of Subjective Global Assessment-Dialysis Malnutrition Score as independent predictor of arteriovenous fistulas thrombosis (vascular access thrombosis) and/or significant stenosis (vascular access stenosis). In addition, we compared it with the widespread Charlson Comorbidity Index...
June 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29849020/adoption-and-application-in-italy-of-the-principal-guidelines-and-international-recommendations-on-venous-access
#5
Rosario Spina, Baudolino Mussa, Lara Tollapi, Fabio Conti, Enrico Cortesi, Roberto Verna
Vascular access is the commonest invasive procedure in secondary care. Vascular access is understood as being access to the bloodstream of acute and chronic patients for diagnostic and therapeutic purposes such as blood sampling, vessel pressure monitoring, fluid infusions (blood transfusions, parenteral nutrition), pharmacological treatments (e.g. antibiotic therapies, chemotherapy, analgesic therapies) or apheresis/dialysis through catheters that may remain in the vessels for weeks or months. There is a wide variety of options available for venous access...
June 2018: Minerva Medica
https://www.readbyqxmd.com/read/29848417/vital-sign-variations-with-complications-during-dialysis-among-end-stage-renal-disease-patients
#6
Abdul Rehman Qureshi, Naureen Durrani, Naila Asif
OBJECTIVE: To analyse the association of vital sign variations with complications during dialysis among end-stage renal disease patients. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Dialysis Centre, Memon Medical Institute Hospital, Karachi, Pakistan, from December 2016 to February 2017. METHODOLOGY: Patients on regular hemodialysis with permanent vascular access were selected. Analysis was done during their regular hemodialysis session...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29793851/evaluation-of-examiner-performance-using-a-duplex-ultrasound-simulator-flow-velocity-measurements-in-dialysis-access-fistula-models
#7
Daniel F Leotta, R Eugene Zierler, Kurt Sansom, Alberto Aliseda, Mark D Anderson, Florence H Sheehan
We developed a duplex ultrasound simulator for training and assessment of scanning skills. We used the simulator to test examiner performance in the measurement of flow velocities in dialysis access fistulas. Test cases were created from 3-D ultrasound scans of two dialysis access fistulas by reconstructing 3-D blood vessel models and simulating blood flow velocity fields within the lumens. The simulator displays a 2-D B-mode or color Doppler image corresponding to transducer position on a mannequin; a spectral waveform is generated according to Doppler sample volume location and system settings...
May 21, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29784566/preoperative-point-of-care-ultrasound-and-its-impact-on-arteriovenous-fistula-maturation-outcomes
#8
Sajjid Hossain, Amit Sharma, Luc Dubois, Guy DeRose, Audra Duncan, Adam H Power
OBJECTIVE: Duplex ultrasound as a preoperative assessment tool in the clinic may help identify anatomic factors predictive of fistula maturation. Preoperative point-of-care ultrasound (POCUS) offers surgeons an alternative to routine formal vein mapping as it can be performed by the operator during the initial clinic visit. We sought to determine the impact of POCUS as an adjunct to physical examination on arteriovenous fistula maturation. METHODS: All consecutive patients undergoing first-time dialysis access creation from December 2007 to December 2014 were retrospectively reviewed...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29758323/why-do-vascular-surgeons-get-sued-analysis-of-claims-and-outcomes-in-malpractice-litigation
#9
John Phair, Eric B Trestman, Eddie Skripochnik, Evan C Lipsitz, Issam Koleilat, Larry A Scher
OBJECTIVE: To analyze causes and outcomes of malpractice claims against vascular surgeons in the United States. METHODS: Cases entered into the Westlaw database from January 1st 1999 to December 31st 2014 were reviewed. Search terms "vascular" and "surgeon" were used. Data was compiled on the allegation, subject matter and outcome of each case. Additional data including demographics of the defendant was obtained from U.S. News Health Reports on practicing physicians...
May 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29736915/planning-and-evaluation-for-vascular-access-in-the-elderly
#10
Candice Halinski, Holly M Koncicki
Vascular access is of vital importance for patients requiring dialysis therapies. AV fistulas have been endorsed by many professional societies as the access of choice, however, subsequent creation does not go without consequences. As the population ages and patients become more medically complex, access failure has become a major cause of treatment complication. For the elderly, this is especially true and there are multiple decision points that require careful reflection before an AVF is placed. This article reviews access considerations for AVF placement in the elderly population and considers the possibility that the fistula first approach to vascular access should not be an absolute...
May 8, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29724122/a-meta-analysis-of-the-association-between-diabetic-patients-and-avf-failure-in-dialysis
#11
Yan Yan, Dan Ye, Liu Yang, Wen Ye, Dandan Zhan, Li Zhang, Jun Xiao, Yan Zeng, Qinkai Chen
PURPOSE: The most preferable vascular access for patients with end-stage renal failure needing hemodialysis is native arteriovenous fistula (AVF) on account of its access longevity, patient morbidity, hospitalization costs, lower risks of infection and fewer incidence of thrombotic complications. Meanwhile, according to National Kidney Foundation (NKF)̸Dialysis Out-comes Quality Initiative (DOQI) guidelines, AVF is more used than before. However, a significant percentage of AVF fails to support dialysis therapy due to lack of adequate maturity...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29703700/improved-patency-of-eptfe-grafts-as-a-hemodialysis-access-site-by-seeding-autologous-endothelial-cells-expressing-fibulin-5-and-vegf
#12
Itai Tzchori, Mizied Falah, Denis Shteynberg, Dana Levin Ashkenazi, Zeev Loberman, Luba Perry, Moshe Y Flugelman
Small caliber synthetic vascular grafts used for dialysis access sites have high failure rates due to neointima formation and thrombosis. Seeding synthetic grafts with endothelial cells (ECs) provides a biocompatible surface that may prevent graft failure. We tested the use of ePTFE grafts seeded with autologous ECs expressing fibulin-5 and vascular endothelial growth factor (VEGF), as a dialysis access site in a porcine model. We connected the carotid arteries and jugular veins of 12 miniature pigs using 7-mm ePTFE grafts; five grafts were seeded with autologous venous ECs modified to express fibulin-5 and VEGF, and seven unseeded grafts were implanted at the same location and served as controls...
April 5, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/29703177/functional-status-pre-dialysis-health-and-clinical-outcomes-among-elderly-dialysis-patients
#13
Silvi Shah, Anthony C Leonard, Charuhas V Thakar
BACKGROUND: Elderly patients comprise the fastest growing population initiating dialysis in United States. The impact of poor functional status and pre-dialysis health status on clinical outcomes in elderly dialysis patients is not well studied. METHODS: We studied a retrospective cohort of 49,645 incident end stage renal disease patients that initiated dialysis between January 1, 2008 and December 31, 2008 from the United States Renal Data System with linked Medicare data covering at least 2 years prior to dialysis initiation...
April 27, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29701407/creative-vascular-access-construction-in-same-patient
#14
Pedro Pinto Sousa, Paulo Almeida, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Creating and maintaining a functional vascular access(VA) is a critical factor in the survival of a dialysis patient. However, it will not function forever, implying a creative attitude from the vascular surgeon either to maintain its functionality or built a new one wherever possible, being it autologous or synthetic. METHODS: Describe the VA history of a 59years-old male with morbid obesity and end-stage chronic kidney disease. RESULTS: His VA construction started in2012 with failed attempts in both forearms until a functional brachiocephalic artery-venous fistula(AVF) in the right upper limb was achieved, but was deemed to ligation as severe venous hypertension secondary to central venous disease related to CVC use...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697182/leadless-pacemaker-placement-in-a-patient-with-chronic-kidney-disease-a-strategy-to-preserve-central-veins
#15
Joan Alberto Maradey, Geoffrey Te Jao, Tushar J Vachharajani
Cardiac rhythm disorder is frequently encountered in hemodialysis patients and is often treated with a cardiovascular implantable electronic device (CIED). The conventional CIED requires placement of transvenous leads resulting in subclinical central venous stenosis, which can adversely affect the successful creation of a permanent dialysis vascular access. The technological advancement of a leadless pacemaker provides an opportunity to implement a strategy to preserve central veins in patients with chronic kidney disease...
April 26, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29689520/brachiocephalic-a-v-fistula-through-the-median-cubital-vein-a-reliable-option-to-failure-of-forearm-fistulas-a-case-report-from-chu-yaound%C3%A3
#16
Marc Leroy Guifo, Denis Georges Teuwafeu, Motto Georges Bwelle, Guy Aristide Bang, Mefiré Alain Chichom, Aurelien Ndoumbe, Arthur Georges Essomba
INTRODUCTION: Renal replacement therapy in end-stage kidney disease relies on dialysis in low-income countries. This maintenance treatment needs a reliable vascular access and is done through central venous catheter or creation of A-V fistulas. Several types of A-V fistulas can be done but due to some individual conditions, those possibilities may be exhausted rapidly. CASE PRESENTATION: A 31 year old female was diagnosed with an end stage renal disease for which she was prescribed maintenance dialysis...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29680297/early-results-of-percutaneous-arteriovenous-fistula-creation-with-the-ellipsys-vascular-access-system
#17
Alexandros Mallios, William C Jennings, Benoit Boura, Alessandro Costanzo, Pierre Bourquelot, Myriam Combes
OBJECTIVE: We reviewed our initial experience creating a percutaneous arteriovenous fistula (pAVF) using a thermal resistance anastomosis device with proximal radial artery inflow. METHODS: A retrospective review was conducted of all patients who underwent a pAVF creation procedure between May 2017 and October 2017. Primary end points of the study were technical success, patency by Doppler ultrasound examination or angiography, flow levels achieved, time to first use, and pAVF-related complications...
April 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29668211/a-payer-provider-partnership-for-integrated-care-of-patients-receiving-dialysis
#18
Justin Kindy, David Roer, Robert Wanovich, Stephen McMurray
OBJECTIVES: Patients with end-stage renal disease (ESRD) are clinically complex, requiring intensive and costly care. Coordinated care may improve outcomes and reduce costs. The objective of this study was to determine the impact of a payer-provider care partnership on key clinical and economic outcomes in enrolled patients with ESRD. STUDY DESIGN:  Retrospective observational study. METHODS: Data on patient demographics and clinical outcomes were abstracted from the electronic health records of the dialysis provider...
April 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29656848/the-discipline-of-epidemiology-engaging-in-the-full-breadth-of-population-health-science
#19
Harold I Feldman
This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology...
June 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29642730/long-term-outcomes-of-bovine-pericardial-patch-angioplasty-for-recurrent-stenosis-in-vascular-access-a-uk-single-centre-experience
#20
Owain Fisher, Lewis Meecham, Pauline Buxton, Jocelyn Legge, Jack Fairhead, Sriram Rajagopalan, John Asquith, Arun Pherwani
INTRODUCTION: Stenosis of an arteriovenous fistula or arteriovenous graft for dialysis is a common problem. Stenosis may lead to a number of problems including failure of the fistula. Treatment of stenosis is commonly with percutaneous angioplasty or surgical patch angioplasty with autologous vein or synthetic graft or patch. Here we report the use of bovine pericardial patch angioplasty as an alternative mode of patch angioplasty when percutaneous intervention has failed. METHODS: Patients with fistulae treated with bovine patch angioplasty between 2013 and 2016 were identified from a prospectively maintained renal access database (Cyberren® )...
April 1, 2018: Journal of Vascular Access
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