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Dialysis vascular access

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https://www.readbyqxmd.com/read/29456217/vascular-access-mortality-and-hospitalization-among-hemodialysis-patients-in-palestine
#1
Sondus A Hamadneh, Saja A Nueirat, Jamal Qadoomi', Mohammed Shurrab, Wajeh Y Qunibi, Zakaria Hamdan
Vascular access complications are common in patients with end-stage kidney disease who are receiving maintenance hemodialysis (HD) and are responsible for an enormous burden of morbidity and mortality among these patients. Differences in the all-cause mortality rate and hospitalization between dialysis catheter use and arteriovenous (AV) vascular access use have not been documented in our HD population. We performed a 12-month prospective analysis of our HD patients from four dialysis centers. We examined all-cause mortality and hospitalization in patients being dialyzed through HD catheters as compared to patients with AV access...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29444477/the-microbiome-in-chronic-kidney-disease-patients-undergoing-hemodialysis-and-peritoneal-dialysis
#2
REVIEW
Liliana Simões-Silva, Ricardo Araujo, Manuel Pestana, Isabel Soares-Silva, Benedita Sampaio-Maia
Chronic kidney disease (CKD) is associated with an imbalanced human microbiome due not only to CKD-associated factors such as uremia, increased inflammation and immunosuppression, but also to pharmacological therapies and dietary restrictions. End-stage renal disease patients require renal replacement therapies commonly in the form of hemodialysis (HD) or peritoneal dialysis (PD). HD implies the existence of a vascular access, such as an arteriovenous fistula/graft or a venous catheter, whereas PD implies a long-term peritoneal catheter and the constant inflow of peritoneal dialysate...
February 11, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29429750/arteriovenous-fistula-maturation-in-prevalent-hemodialysis-patients-in-the-united-states-a%C3%A2-national%C3%A2-study
#3
Kenneth J Woodside, Sarah Bell, Purna Mukhopadhyay, Kaitlyn J Repeck, Ian T Robinson, Ashley R Eckard, Sudipta Dasmunshi, Brett W Plattner, Jeffrey Pearson, Douglas E Schaubel, Ronald L Pisoni, Rajiv Saran
BACKGROUND: Arteriovenous fistulas (AVFs) are the preferred form of hemodialysis vascular access, but maturation failures occur frequently, often resulting in prolonged catheter use. We sought to characterize AVF maturation in a national sample of prevalent hemodialysis patients in the United States. STUDY DESIGN: Nonconcurrent observational cohort study. SETTING & PARTICIPANTS: Prevalent hemodialysis patients having had at least 1 new AVF placed during 2013, as identified using Medicare claims data in the US Renal Data System...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29424185/predictors-of-early-failure-and-secondary-patency-in-native-arteriovenous-fistulas-for-hemodialysis
#4
Rui Abreu, Sara Rioja, Joaquin Vallespin, Xavier Vinuesa, Ruben Iglesias, Jose Ibeas
BACKGROUND: Native arteriovenous fistula (AVF) is considered the gold standard of vascular access for hemodialysis due to its longer survival, fewer complications, lower mortality and costs. Patency is important for effective dialysis treatment and this remains a challenge in nephrology. There are no well-defined prognostic factors for early and long-term AVF survival. The aim of this study was to evaluate comorbidity, analytical and ultrasound (US) variables as prognostic factors for early failure and AVF patency...
February 8, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29411718/glucose-pump-test-can-be-used-to-measure-blood-flow-rate-of-native-arteriovenous-fistula-in-chronic-hemodialysis
#5
Y C Yavuz, N Y Selcuk, L Altıntepe, I Güney, S Yavuz
PURPOSE: In chronic hemodialysis patients, the low flow of vascular access may leads to inadequate dialysis, increased rate of hospitalization, morbidity, and mortality. It was found that surveillance should be performed for native arteriovenous (AV) should not be performed for AV graft in various studies. However, surveillance was done in graft AV fistulas in most studies. Doppler ultrasonography (US) was suggested for surveillance of AV fistulas by the last vascular access guideline of National Kidney Foundation Disease Outcomes Quality Initiative (NKF KDOQI)...
January 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29409160/decreasing-hospitalizations-in-patients-on-hemodialysis-time-for-a-paradigm-shift
#6
REVIEW
Ladan Golestaneh
Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care-sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categories include: (1) fluid (interdialytic weight gain (IDWG) and chronic volume status), (2) infection (vascular access and malnutrition/inflammation resilience), and c) psychosocial (poor social support, poor self-efficacy, and mood disorders) risks...
February 6, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29407339/emergency-kidney-transplantation-in-recipients-with-iliocaval-thrombosis-using-splenic-vessel-anastomosis-after-splenectomy-a-case-series
#7
M Spaggiari, C Di Bella, P Di Cocco, S Furno, E Benedetti, I Tzvetanov
BACKGROUND: The external iliac vein is the standard site used for venous anastomosis in kidney transplantation. When a pre-transplantation diagnosis of iliocaval thrombosis is established, a different and suitable venous drainage for the renal outflow must be identified for successful transplant. METHODS: We report 4 cases of kidney transplantation, performed from 2004 to 2016, in recipients presenting with thrombosis of the inferior vena cava and iliac system needing, because of the lack of access for dialysis, urgent kidney transplantations...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29401294/the-first-365-days-on-haemodialysis-variation-in-the-haemodialysis-access-journey-and-its-associated-burden
#8
Eleanor Murray, Mahmoud Eid, Jamie P Traynor, Karen S Stevenson, Ram Kasthuri, David B Kingsmore, Peter C Thomson
Background: The modality by which haemodialysis (HD) is delivered [arteriovenous fistula (AVF), arteriovenous graft (AVG) or central venous catheter (CVC)] varies widely and is influenced by clinical evidence, patient factors and the prevailing service configuration. The aim of this study was to determine the outcome and impact of access strategy on patient outcome by mapping out the HD journey in a cohort of incident patients. Methods: A 2-year cohort of consecutive incident HD patients from the point of referral for first dialysis access to completion of the first 365 days of HD was prospectively reviewed...
February 1, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29391102/the-burden-of-tunneled-central-venous-catheters-for-hemodialysis-in-a-county-hospital
#9
Eric Pillado, Abraham Korn, Christian de Virgilio, Nina Bowens
Prolonged use of central venous catheters (CVCs) for hemodialysis (HD) is associated with greater morbidity and mortality when compared with autogenous arteriovenous fistulas (AVF). The objective was to assess compliance with CVC guidelines in adults referred for hemoaccess at a county teaching hospital. Out of 256 patients, 172 (67.2%) were male, with a mean age of 50.0 ± 12.4 years. Overall 62.5 per cent initiated dialysis via CVC. Patients were divided into two groups (those with CVC (62.5%) and those without (37...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29349919/analysis-of-follow-up-methods-of-vascular-access-and-patient-outcomes-in-hemodialysis-at-a-tertiary-care-hospital-in-china
#10
Ying Zhang, Xianglei Kong, Lijun Tang, Yong Wei, Dongmei Xu
Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit...
January 19, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29348924/mortality-and-hospitalizations-in-intensive-dialysis-a-systematic-review-and-meta-analysis
#11
Anna Mathew, Jody-Ann McLeggon, Nirav Mehta, Samuel Leung, Valerie Barta, Thomas McGinn, Gihad Nesrallah
Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29343519/uremic-solute-aryl-hydrocarbon-receptor-tissue-factor-axis-associates-with-thrombosis-after-vascular-injury-in-humans
#12
Vijaya B Kolachalama, Moshe Shashar, Faisal Alousi, Sowmya Shivanna, Keshab Rijal, Mostafa E Belghasem, Joshua Walker, Shinobu Matsuura, Gary H Chang, C Michael Gibson, Laura M Dember, Jean M Francis, Katya Ravid, Vipul C Chitalia
Individuals with CKD are particularly predisposed to thrombosis after vascular injury. Using mouse models, we recently described indoxyl sulfate, a tryptophan metabolite retained in CKD and an activator of tissue factor (TF) through aryl hydrocarbon receptor (AHR) signaling, as an inducer of thrombosis across the CKD spectrum. However, the translation of findings from animal models to humans is often challenging. Here, we investigated the uremic solute-AHR-TF thrombosis axis in two human cohorts, using a targeted metabolomics approach to probe a set of tryptophan products and high-throughput assays to measure AHR and TF activity...
January 17, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29319771/peritoneal-dialysis-as-the-first-dialysis-treatment-option-initially-unplanned
#13
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29314570/transubclavian-approach-a-competitive-access-for-transcatheter-aortic-valve-implantation-as-compared-to-transfemoral
#14
Ignacio J Amat-Santos, Paol Rojas, Hipólito Gutiérrez, Silvio Vera, Javier Castrodeza, Javier Tobar, L Renier Goncalves-Ramirez, Manuel Carrasco, Pablo Catala, José A San Román
AIMS: Empirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence. METHODS: We systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017...
January 3, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314256/point-of-care-ultrasound-education-to-improve-care-of-dialysis-patients
#15
Surekha Mullangi, Stephen M Sozio, Paul Segal, Steven Menez, Carol Martire, Tariq Shafi
Point-of-care ultrasound (POCUS) is rapidly emerging as a bedside diagnostic tool that can enhance physical diagnosis and facilitate clinical decision making. Although ultrasound is widely used by nephrologists for vascular access and kidney imaging, diagnostic POCUS skills in other anatomic areas are not part of routine nephrology training. In this narrative review, we will provide an overview of selected POCUS techniques, highlight potential uses of POCUS in routine nephrology practice, and describe a new curriculum implemented at Johns Hopkins University School of Medicine to teach diagnostic POCUS skills to nephrology fellows...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29301135/a-retrospective-analysis-of-dialysis-events-over-a-3-year-period-in-an-outpatient-dialysis-unit-in-the-state-of-kuwait
#16
Moustapha Ramadan, Gautam Hebbar
OBJECTIVE: To determine the difference in the rates of dialysis events stratified by vascular access type and to describe the microbiological profile and sensitivity patterns of positive blood cultures over a 3-year period. SUBJECTS AND METHODS: The dialysis event data of 10751 chronic hemodialysis patients collected from March 2013 to February 2016 at an Outpatient Dialysis Unit in Kuwait were reviewed. The dialysis events studied were; use of intravenous (IV) antimicrobials, positive blood culture and signs of inflammation at the vascular access site...
January 4, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29275056/the-pivotal-multicenter-trial-of-ultrasound-guided-percutaneous-arteriovenous-fistula-creation-for-hemodialysis-access
#17
Jeffrey E Hull, William C Jennings, Randy I Cooper, Umar Waheed, Matthew E Schaefer, Rajeev Narayan
PURPOSE: To evaluate safety and efficacy of arteriovenous fistulas (AVFs) created with a thermal resistance anastomosis device. MATERIALS AND METHODS: A prospective single-arm trial at 5 sites enrolled 107 patients. Patients underwent ultrasound (US)-guided anastomosis creation between the proximal radial artery and perforating vein with the Ellipsys Vascular Access System (Avenu Medical, Inc, San Juan Capistrano, California) followed by separate maturation procedures...
December 21, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#18
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
December 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29218694/training-vascular-access-surgeons-technicians-or-specialists
#19
Nicholas Inston, Tej M Singh
Internationally, vascular access (VA) surgery is delivered in a varied and diverse fashion and subsequently, training in vascular access is poorly defined. Experience of VA during surgical training has implications on future practice. The scope of VA procedures is increasing, yet the focus in vascular training remains largely in the technical aspects of surgery rather than the more comprehensive aspects of surgery applied to dialysis and renal care. To achieve special skills in vascular access surgery may require a change to traditional training with an additional focus on developing an extended portfolio of knowledge and skills...
December 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29212839/bp-in-dialysis-results-of-a-pilot-study
#20
Dana C Miskulin, Jennifer Gassman, Ronald Schrader, Ambreen Gul, Manisha Jhamb, David W Ploth, Lavinia Negrea, Raymond Y Kwong, Andrew S Levey, Ajay K Singh, Antonia Harford, Susan Paine, Cynthia Kendrick, Mahboob Rahman, Philip Zager
The optimal BP target for patients receiving hemodialysis is unknown. We randomized 126 hypertensive patients on hemodialysis to a standardized predialysis systolic BP of 110-140 mmHg (intensive arm) or 155-165 mmHg (standard arm). The primary objectives were to assess feasibility and safety and inform the design of a full-scale trial. A secondary objective was to assess changes in left ventricular mass. Median follow-up was 365 days. In the standard arm, the 2-week moving average systolic BP did not change significantly during the intervention period, but in the intensive arm, systolic BP decreased from 160 mmHg at baseline to 143 mmHg at 4...
January 2018: Journal of the American Society of Nephrology: JASN
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