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Dialysis. Access

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https://www.readbyqxmd.com/read/28930731/uk-renal-registry-19th-annual-report-chapter-12-multisite-dialysis-access-audit-in-england-northern-ireland-and-wales-in-2015-and-2014-pd-one-year-follow-up-national-and-centre-specific-analyses
#1
Barnaby Hole, Fergus Caskey, Katharine Evans, Richard Fluck, Mick Kumwenda, Retha Steenkamp, Martin Wilkie
No abstract text is available yet for this article.
2017: Nephron
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#2
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/28929524/off-pump-cabg-with-lower-sternotomy-in-a-patient-with-dialysis-access-graft-crossing-the-sternum
#3
Michael Magarakis, Tomas A Salerno, Alejandro E Macias, Nicolas A Brozzi
No abstract text is available yet for this article.
September 20, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#4
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/28925068/when-and-how-can-nephrologists-treat-hepatitis-c-virus-infection-in-dialysis-patients
#5
REVIEW
Maya I Davis, Donald F Chute, Raymond T Chung, Meghan E Sise
Hepatitis C virus (HCV) infection, a major cause of end-stage liver disease, is a common comorbidity in patients on dialysis and causes increased morbidity and mortality. Historically HCV has been extremely difficult to cure with interferon and ribavirin-based therapies, which are also associated with significant side effects, and few dialysis patients ever received HCV treatment. However, in the last 4 years, interferon-free direct-acting antiviral therapies have been approved, and several combinations have been studied in dialysis patients...
September 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28918595/successful-pregnancy-in-a-ckd-patient-on-a-low-protein-supplemented-diet-an-opportunity-to-reflect-on-ckd-and-pregnancy-in-mexico-an-emerging-country
#6
Julia Nava, Silvia Moran, Veronica Figueroa, Adriana Salinas, Margy Lopez, Rocio Urbina, Abril Gutierrez, Jose Luis Lujan, Alejandra Orozco, Rafael Montufar, Giorgina B Piccoli
Pregnancy is probably the most important challenge in young women with chronic kidney disease (CKD). The challenge is greater in developing countries, in which access to dialysis is uneven, and prenatal care for CKD patients is not uniformly available. This case report summarizes some of the challenges faced by pregnant CKD women in a developing country. A 35-year-old woman, affected by an undiagnosed kidney disease, experienced preeclampsia at 24 years of age, and started dialysis in emergency at age 31 in the context of severe preeclampsia in her second pregnancy...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28916306/end-to-side-versus-side-to-side-anastomosis-in-upper-limb-arteriovenous-fistula-for-dialysis-access-a-systematic-review-and-a-meta-analysis
#7
Khalid Bashar, Mekki Medani, Hiba Bashar, Khalid Ahmed, Thomas Aherne, Tony Moloney, Stewart R Walsh
OBJECTIVES: To systematically assess the difference between both procedures in terms of access maturation, patency and postoperative complications. BACKGROUND: An arteriovenous fistula (AVF) is the best modality for haemodialysis (HD) access. The end-to-side (ETS) technique has been suggested in the literature to produce superior results to the side-to-side approach; however, in the absence of a systematic review, this practice remains debatable. METHODS: Online search for randomised controlled trials (RCTs) and observational studies that compared the end-to-side versus the side-to-side anastomosis techniques in creating an upper limb AVF...
September 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28913721/intraperitoneal-antibiotic-administration-for-prevention-of-postoperative-peritoneal-catheter-related-infections
#8
Margarita Kunin, Dganit Dinour, Danny Rosin
BACKGROUND: It is recommended that systemic prophylactic antibiotics be given immediately prior to peritoneal catheter insertion. This administration requires intravenous access and could be inconvenient in dynamic and unpredictable operation room schedule. Intraperitoneal antibiotics could be an alternative simple way for prevention of postoperative peritoneal catheter infections. METHODS: Medical records from 109 patients undergoing permanent PD catheter placement procedures were reviewed retrospectively...
September 14, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28912005/proximal-radial-artery-arteriovenous-fistula-for-hemodialysis-vascular-access
#9
William C Jennings, Alexandros Mallios, Nasir Mushtaq
OBJECTIVE: This study reviewed our experience with proximal radial artery-based arteriovenous fistulas (PRA-AVFs) for hemodialysis vascular access, evaluating characteristics of the patients, functional patency, risk of steal syndrome, survival of the patient, and technical considerations. METHODS: We retrospectively analyzed our database of consecutive patients, identifying those individuals with a PRA-AVF created during a 12-year period. In addition to physical examination, all patients underwent ultrasound vessel mapping by the operating surgeon, identifying the PRA-AVF configuration and outflow target most likely to succeed...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28910799/effects-of-hemodialysis-therapy-using-dialyzers-with-medium-cut-off-membranes-on-middle-molecules
#10
Alexander H Kirsch, Alexander R Rosenkranz, Raphael Lyko, Detlef H Krieter
The removal of larger middle molecules, such as free immunoglobulin light chains (FLC), is poor with most currently used dialysis technologies. While hemodiafiltration (HDF) provides enhanced clearance of middle molecules compared to high-flux hemodialysis (HD), this technique is currently not approved in some regions and, hence, not accessible for all patients. The retention of middle molecules is thought to be one factor, which contributes to excessive morbidity and mortality in HD patients. The development of medium cut-off (MCO) dialysis membranes is aimed at a more efficient clearance of larger uremic toxins while retaining albumin and may extend the benefit of enhanced solute removal to more patients...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28904934/comparison-of-complications-of-arteriovenous-fistula-with-permanent-catheter-in-hemodialysis-patients-a-six-month-follow-up
#11
Ali Momeni, Saeed Mardani, Maryam Kabiri, Masoud Amiri
BACKGROUND: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis procedure. Due to insufficient reliable information on the comparison between AVF and PC, this study was conducted to compare AVF and PC regarding dialysis adequacy. MATERIALS AND METHODS: This prospective study was carried out from March, 2013 to September, 2013. In this study, 76 hemodialysis patients were enrolled and assigned to two unequal groups of AVF and PC...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28904808/intracardiac-fistula-an-unusual-complication-of-catheter-related-blood-stream-infection
#12
Abhilash Koratala, Hussain Aboud, Robert Gibson, Karen K Hamilton
In end stage renal disease patients on dialysis, the use of catheter as a vascular access is associated with a significant risk of sepsis compared to an arterio-venous fistula. Our case emphasizes the importance of having high index of suspicion for unusual complications in patients presenting with possible catheter-related blood stream infection and early use of complementary tools such as trans-oesophageal echocardiography whenever applicable.
September 2017: JRSM Open
https://www.readbyqxmd.com/read/28902768/economic-and-clinical-outcomes-resulting-from-the-stage-4-chronic-kidney-disease-case-management-quality-improvement-initiative
#13
Beverly Everett, Liana D Castel, Matthew McGinnis, Amy Beresky, Rudolph C Cane, Tasha Cooper, Rajesh K Davda, Donna Farmer, Stella M John, Denise L Sollars, John F Rausch
PURPOSE OF STUDY: Chronic kidney disease (CKD) is a costly and burdensome public health concern. The goal of this study was to evaluate the impact on outcomes and utilization of a pilot program to identify and engage beneficiaries with CKD at risk for progression from Stage 4 to Stage 5. PRIMARY PRACTICE SETTINGS: A quality improvement initiative was conducted to assess the impact of case management on costs and outcomes among 7,720 Cigna commercial medical beneficiaries with Stage 4 CKD enrolled in the United States between January 2012 and October 2012...
September 11, 2017: Professional Case Management
https://www.readbyqxmd.com/read/28899228/intraoperative-venoplasty-to-facilitate-placement-of-tunneled-catheters-for-hemodialysis
#14
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective With the implementation of the K-DOQI guidelines, more patients are in need of long-term dialysis catheters until maturation of the arteriovenous fistula. However, on occasion, when placing a tunneled cuffed catheter for hemodialysis, we have encountered difficulty with passing the guidewire in spite of demonstration of a patent cervical portion of the internal jugular vein on duplex. Herein, we review our experience with intraoperative venoplasty for placement of Tesio™ catheters (Medcomp Harleysville, PA)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28898574/integrating-kidney-transplantation-into-value-based-care-for-people-with-renal-failure
#15
Benjamin E Hippen, Franklin W Maddux
Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#16
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28893419/telenephrology-current-perspectives-and-future%C3%A2-directions
#17
Rajeev Rohatgi, Michael J Ross, Sandawana W Majoni
There is increasing interest in telemedicine among physicians and patients; however, the evidence regarding the quality of care delivered by telemedicine, and telenephrology in particular, compared with in-person care is limited. In this review, different electronic modalities used to deliver nephrology care are reviewed and critiqued, with a focused analysis from the Australian and United States perspectives. Both countries are geographically expansive with significant rural populations where access to nephrology care is limited...
September 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28887265/modified-staple-aneurysmorrhaphy-for-treating-arteriovenous-fistula-related-venous-aneurysms
#18
R Moskowitz, E Fakhoury, K James
Autogenous arteriovenous fistulas (AVF) are the preferred access for hemodialysis. AVF occasionally develop venous aneurysms and we report a modified staple aneurysmorrhaphy technique for treatment. Briefly, the lateral wall of the venous aneurysm is dissected and a longitudinal staple resection performed. Adjunct procedures include inflow banding and outflow venous angioplasty with possible stenting. In this initial experience, 20 aneurysms were resected in 17 patients. The average AVF age at time of repair was 5...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887240/temporal-trends-determinants-and-outcomes-of-inpatient-versus-outpatient-arteriovenous-fistula-operations
#19
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
ObjectivesAs high health care costs are increasing scrutinized, a movement toward reducing patient hospital admissions and lengths of stay has emerged, particularly for operations that may be performed safely in the outpatient setting. Our aim is to describe recent temporal trends in the proportion of dialysis access procedures performed on an inpatient vs. outpatient basis, and to determine the effects of these changes on perioperative morbidity and mortality. MethodsThe 2005-2008 ACS NSQIP database was queried for all primary arteriovenous fistula (AVF) procedures using CPT codes...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885654/what-is-the-best-setting-for-receiving-dialysis-vascular-access-repair-and-maintenance-services
#20
Audrey M El-Gamil, Al Dobson, Nikolay Manolov, Joan E DaVanzo, Gerald A Beathard, Terry Foust Litchfield, Brook Cowin
INTRODUCTION: Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC)...
September 2, 2017: Journal of Vascular Access
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