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Dialysis. Access

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https://www.readbyqxmd.com/read/29156003/chronic-respiratory-disease-an-unrecognized-risk-factor-in-dialysis
#1
Cécile Couchoud, Clémence Béchade, Abdelkader Bemrah, Jean-Christophe Delarozière, Guillaume Jean
Background: Few studies have analysed the impact of chronic respiratory disease (CRD) on outcomes in dialysis. We therefore sought to describe patients with CRD and end-stage renal disease and their outcomes after dialysis start, compared with patients without CRD, focusing especially on causes of death, access to renal transplantation and causes of hospital admissions. Methods: The study included 52 797 adults aged 18 years and older who began dialysis from 2008 to 2013 and are recorded in the French national REIN registry...
May 30, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#2
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29148024/blue-planet-dialysis-novel-water-sparing-strategies-for-reducing-dialysate-flow
#3
Alejandra Molano-Triviño, Benjamin Wancjer, Mauro M Neri, Akash N Karopadi, Mitchell Rosner, Claudio Ronco
INTRODUCTION: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. METHODS: We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux...
November 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29148012/use-of-bovine-carotid-artery-for-buttonhole-technique-hemodialysis
#4
Earl Schuman, Philip Alexander, Amy Ronfeld
PURPOSE: Assess the feasibility of using a bovine carotid artery graft for buttonhole technique hemodialysis in patients who are not candidates for a native fistula. METHODS: Case reports used to demonstrate selection criteria and results for this approach. Criteria include: knowledgeable patient with prior dialysis experience, stable graft in place for 3 months minimum, not a candidate for a native fistula, and able to maintain close follow-up. RESULTS: Both grafts were based on axillary vessels and have been in place for a total of 64 months...
November 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148006/autogenous-forearm-loop-arteriovenous-fistula-creation
#5
Weng Jun Tang, Arman Zaharil Mat Saad
INTRODUCTION: Arteriovenous fistula is a lifeline for end-stage kidney disease patients on dialysis. The quality of the vein and artery to be used plays a crucial role in attaining a functioning, reliable and long-lasting arteriovenous fistula. The aim of the study is to present an alternative for haemodialysis access to preserve the upper arm vasculature for future use - the forearm loop arteriovenous fistula. METHODS: From October 2015 to September 2016, 202 patients with chronic kidney disease (CKD), stages 4 and 5, underwent arteriovenous fistula creation at the Universiti Sains Malaysia Hospital, Malaysia...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#6
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147997/drug-eluting-balloon-angioplasty-for-assisted-maturation-of-failing-fistulae
#7
Alexandros Mallios, Jeffrey Hull, Benoit Boura, Alessandro Costanzo, Myriam Combes
OBJECTIVE: To present our experience of balloon-assisted maturation with drug-eluting balloon dilation in patients with recurrent failing arteriovenous fistulae. CASE SERIES: Three patients (all males, mean age 71 years) with a complex history of failed attempts at native fistula creation underwent surgical creation of arteriovenous fistulae. Two patients had a two-stage brachio-brachial fistula and 1 had a brachio-cephalic fistula that also required subsequent elevation...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29145509/untargeted-mass-spectrometry-discloses-plasma-solute-levels-poorly-controlled-by-hemodialysis
#8
Tammy L Sirich, Pavel A Aronov, Jonathan Fullman, Khanh Nguyen, Natalie S Plummer, Timothy W Meyer
Many solutes have been reported to remain at higher plasma levels relative to normal than the standard index solute urea in hemodialysis patients. Untargeted mass spectrometry was employed to compare solute levels in plasma and plasma ultrafiltrate of hemodialysis patients and normal subjects. Quantitative assays were employed to check the accuracy of untargeted results for selected solutes and additional measurements were made in dialysate and urine to estimate solute clearances and production. Comparison of peak areas indicated that many solutes accumulated to high levels in hemodialysis patients, with average peak areas in plasma ultrafiltrate of dialysis patients being more than 100 times greater than those in normals for 123 features...
2017: PloS One
https://www.readbyqxmd.com/read/29131451/what-we-do-and-do-not-know-about-women-and-kidney-diseases-questions-unanswered-and-answers-unquestioned-reflection-on-world-kidney-day-and-international-woman-s-day
#9
EDITORIAL
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
Chronic Kidney Disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health and specifically their kidney health, on the community, and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly...
November 13, 2017: Nephrology
https://www.readbyqxmd.com/read/29130991/pre-end-stage-renal-disease-hemoglobin-variability-predicts-post-end-stage-renal-disease-mortality-in-patients-transitioning-to-dialysis
#10
Keiichi Sumida, Charles Dyer Diskin, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Connie M Rhee, Elani Streja, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Hemoglobin variability (Hb-var) has been associated with increased mortality both in non-dialysis dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD) patients. However, the impact of Hb-var in advanced NDD-CKD on outcomes after dialysis initiation remains unknown. METHODS: Among 11,872 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 through September 2011, we assessed Hb-var calculated from the residual SD of at least 3 Hb values during the last 6 months before dialysis initiation (prelude period) using within-subject linear regression models, and stratified into quartiles...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130580/stent-use-for-hemodialysis-access-what-a-general-nephrologist-needs-to-know
#11
REVIEW
Siddiq Anwar, Tushar J Vachharajani
Recurrent stenosis due to neo-intimal hyperplasia leads to loss of patency in an established hemodialysis access. The current treatment strategy to maintain patency involves percutaneous transluminal angioplasty with or without stent placement. There are several key points that an interventionalist needs to weigh before deciding to place a stent. These include appropriateness of stent placement, the long term consequences, the type of stent to be deployed, the size of stent and finally the impact on cannulation during dialysis...
November 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29123006/outcomes-of-simultaneous-peritoneal-dialysis-and-arteriovenous-fistula-placement-in-end-stage-renal-disease-patients
#12
Nosratollah Nezakatgoo, Albert Ndzengue, Manhunath Ramaiah, Elvira O Gosmanova
Peritoneal dialysis (PD) interruption requiring hemodialysis (HD) is not uncommon and its frequently abrupt nature prevents timely creation of permanent HD access and avoidance of central venous catheters (CVC). We retrospectively studied a cohort of 24 end-stage renal disease (ESRD) patients (mean age 50.7 years, 83.3% African-Americans, 58.3% females, time on dialysis interquartile range [IQR] 0 - 65 days) who had simultaneous PD catheter insertion and backup arteriovenous fistula (AVF) creation between January 1, 2012, and December 31, 2013...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#13
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29117811/a-new-endovascular-technique-for-the-treatment-of-dialysis-associated-steal-syndrome
#14
Enrico Ascher, Jacob E Mandel, Natalie A Marks, Anil P Hingorani
Background Dialysis access-associated steal syndrome is a major complication of arteriovenous fistula creation whereby the low-resistance venous conduit shunts arterial inflow through the anastomosis, resulting in clinically significant distal artery insufficiency. Herein, we describe a case of severe steal phenomenon with gangrene of a digit following placement of an arteriovenous fistula that was treated with a novel, entirely endovascular technique. To our knowledge, this was the first totally endovascular approach to dialysis access-associated steal syndrome...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29112475/transjugular-venous-approach-for-endovascular-interventions-in-hemodialysis-grafts-and-fistulas-of-the-upper-extremities
#15
Hector Ferral, Marc J Alonzo
OBJECTIVE: This article describes the use of a transjugular venous access for interventions in upper extremity hemodialysis arteriovenous fistulas (AVFs) and grafts. This access is used in selected patients in whom direct puncture of the hemodialysis access is considered to be difficult or cumbersome. Technical success was achieved in 96.7% of patients. If an intervention is unsuccessful, the transjugular access offers the possibility of placement of a dialysis catheter for temporary or long-term hemodialysis...
November 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#16
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29103931/timely-thrombectomy-can-improve-patency-of-hemodialysis-arteriovenous-fistulas
#17
Mu-Yang Hsieh, Lin Lin, Tsung-Yan Chen, Dao-Ming Chen, Ming-Hsien Lee, Yung-Fang Shen, Chung-Wei Yang, Shao-Yuan Chuang, Chih-Cheng Wu, Kuan-Yu Hung
OBJECTIVE: The urgency with which salvage of thrombosed vascular accesses for dialysis should be attempted remains unknown. We examined the effect of a timely thrombectomy approach on vascular access outcomes for dialysis. METHODS: A before-and-after study was conducted with patients on hemodialysis who had undergone endovascular thrombectomy. A timely thrombectomy initiative (ie, salvage within 24 hours of thrombosis diagnosis) was started in July 2015 at our institution...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29080304/high-resolution-computational-fluid-dynamic-simulation-of-haemodialysis-cannulation-in-a-patient-specific-arteriovenous-fistula
#18
David Fulker, Bogdan Ene-Iordache, Tracie J Barber
Arteriovenous fistulae are the preferred choice of vascular access in hemodialysis patients, however complications such as stenosis can lead to access failure or recirculation, which reduces dialysis efficiency. This study utilized computational fluid dynamics on a patient specific radio-cephalic fistula under hemodialysis treatment to determine the dynamics of access recirculation and identify the presence of disturbed flow. Metrics of transverse wall shear stress and oscillatory shear index were used to characterize the disturbed flow acting on the blood vessel wall, whilst a power spectral density analysis was used to calculate the any turbulence within the access...
October 28, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29076517/association-between-post-dialysis-hemoglobin-level-and-the-survival-of-vascular-access
#19
Hiroki Nishiwaki, Takeshi Hasegawa, Tatsuyoshi Ikenoue, Naoto Tominaga, Masahiko Yazawa, Hiroo Kawarazaki, Yugo Shibagaki, Yosuke Yamamoto, Shingo Fukuma, Shin Yamazaki, Shunichi Fukuhara
INTRODUCTION: Although a few dialysis facilities conduct a complete blood cell count for some patients at post-dialysis, including hemoglobin, clinical findings supporting the interpretation of results are scarce. The aim of this study was to investigate the association between post-dialysis hemoglobin level and vascular access failure with clinical data. METHODS: Study design: Case crossover design. Setting: Japanese dialysis facilities, which routinely take post-dialysis blood samples, including complete blood cell counts at least once a month...
October 24, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29074817/association-of-kidney-transplantation-with-survival-in-patients-with-long-dialysis-exposure
#20
Caren Rose, Jagbir Gill, John S Gill
BACKGROUND AND OBJECTIVES: Evidence that kidney transplantation is associated with better survival compared to dialysis stems from data in populations with short durations of dialysis exposure. Recent changes in allocation policy increase access to transplantation for patients with longer dialysis exposure. The objective of this study was to determine the association of transplantation with survival in patients with ≥10 years of dialysis treatment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our study of n=5365 patients in the Scientific Registry of Transplant Recipients determined the adjusted relative risk of death in recipients of a deceased donor kidney transplant after ≥10 years of dialysis treatment compared with waitlisted patients with the same dialysis exposure in a time-dependent nonproportional hazards analysis...
October 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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