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https://www.readbyqxmd.com/read/29221439/catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-cohort-study
#1
Stephanie Thompson, Natasha Wiebe, Scott Klarenbach, Rick Pelletier, Brenda R Hemmelgarn, John S Gill, Braden J Manns, Marcello Tonelli
BACKGROUND: For people requiring hemodialysis, infectious mortality is independently associated with geographic distance from a nephrologist. We aimed to determine if differential management of catheter-related blood stream infections (CRBSIs) could explain poorer outcomes. METHODS: We prospectively collected data from adults initiating hemodialysis with a central venous catheter between 2005 and 2015 in Alberta, Canada. We collected indicators of CRBSI management (timely catheter removal, relapsing bacteremia); frequency of CRBSIs; hospitalizations; predictors of CRBSIs, and bacteremia...
December 8, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29217892/bowel-migration-of-dormant-chronic-ambulatory-peritoneal-dialysis-catheter-a-vexed-problem-not-avoided-by-flushing
#2
P Vincent, J Gopinathan, R Narayanan
Delayed bowel erosion by peritoneal dialysis catheter is rare with fewer than thirty cases having been reported in the literature. This complication is usually encountered when the catheter is kept dormant. Two cases have also been reported with catheters in active use. The risk factors for bowel erosion include immunosuppression, diverticulosis, and amyloidosis. An 80-year-old male with chronic kidney disease Stage 5 due to hypertensive nephrosclerosis underwent chronic ambulatory peritoneal dialysis catheter insertion...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29217372/acute-peritoneal-dialysis-in-neonatal-intensive-care-unit-an-8-year-experience-of-a-referral-hospital
#3
Aslihan Kara, Metin Kaya Gurgoze, Mustafa Aydin, Erdal Taskin, Unal Bakal, Aysen Orman
BACKGROUND: The aim of present study was to evaluate the indications, complications and outcomes of acute peritoneal dialysis (APD) in neonates at a referral university hospital during the previous 8 years. METHODS: This retrospective analysis included a total of 52 newborn infants who underwent APD in a neonatal intensive care unit between January 2008 and March 2016. Demographic, clinical, laboratory and microbiological data were extracted from patients' medical files...
November 16, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29202728/non-tunneled-versus-tunneled-dialysis-catheters-for-acute-kidney-injury-requiring-renal-replacement-therapy-a-prospective-cohort-study
#4
Mallika L Mendu, Megan F May, Arnaud D Kaze, Dionne A Graham, Salena Cui, Margaret E Chen, Naomi Shin, Ayal A Aizer, Sushrut S Waikar
BACKGROUND: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is associated with high morbidity, mortality and resource utilization. The type of vascular access placed for AKI-RRT is an important decision, for which there is a lack of evidence-based guidelines. METHODS: We conducted a prospective cohort study over a 16-month period with 154 patients initiated on AKI-RRT via either a non-tunneled dialysis catheter (NTDC) or a tunneled dialysis catheter (TDC) at an academic hospital...
December 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29194344/direct-peritoneal-resuscitation-alters-leukocyte-infiltration-in-the-lung-after-acute-brain-death
#5
Jessica L Weaver, Paul J Matheson, Amy Matheson, Cynthia D Downard, R Neal Garrison, Jason W Smith
BACKGROUND: Brain death is associated with significant lung injury and inflammation. This has been associated with worse long-term outcomes for transplanted lungs. Direct peritoneal resuscitation (DPR) reduces systemic inflammation in brain death and improves lung procurement rate. The effect of DPR on macrophage and neutrophil infiltration in the lungs is not known. METHODS: Male Sprague-Dawley rats had a 4F Fogarty catheter inserted into the skull and the balloon inflated until brain death was achieved...
November 30, 2017: Shock
https://www.readbyqxmd.com/read/29194322/direct-peritoneal-resuscitation-reduces-intestinal-permeability-after-brain-death
#6
Jessica L Weaver, Paul J Matheson, Amy Matheson, Brian G Harbrecht, Cynthia D Downard, R Neal Garrison, Jason W Smith
BACKGROUND: The profound inflammatory response associated with brain death is frequently cited as the reason organs procured from brain dead donors are associated with worse graft function. The intestine releases inflammatory mediators in other types of shock, but its role is brain death has not been well-studied. Direct peritoneal resuscitation (DPR) improves visceral organ blood flow and reduces inflammation after hemorrhagic shock. We hypothesized that use of DPR would maintain intestinal integrity and reduce circulating inflammatory mediators after brain death...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29192722/cephalic-vein-transposition-is-a-durable-approach-to-managing-cephalic-arch-stenosis
#7
Jon C Henry, Ulka Sachdev, Eric Hager, Ellen Dillavou, Theodore Yuo, Michel Makaroun, Steven A Leers
INTRODUCTION: The proximal cephalic vein that enters the axillary vein (cephalic arch) is a common site of stenosis in patients with upper extremity arteriovenous fistulas for hemodialysis (HD). In this study, we present the outcomes of a series of cephalic vein transposition, to determine its utility in the setting of refractory arch stenosis. METHODS: We conducted a retrospective review of patients undergoing cephalic vein transposition to manage refractory cephalic arch stenosis from January 1, 2008 to August 31, 2015...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29192721/haemodialysis-vascular-access-current-practices-amongst-indian-nephrologists
#8
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29191576/-comparison-of-citrate-4-and-heparin-as-tunneled-catheters-locking-solution-in-chronic-hemodialysis
#9
Guillaume Chazot, Manolie Mehdi, Christie Lorriaux, Patrik Deleaval, Brice Mayor, Guillaume Jean, Charles Chazot, Sylvain Lechevallier, Oriane Moncel, Cyril Vo-Van, Jean-Marc Hurot
INTRODUCTION: Citrate 4% is an alternative to heparin as catheter-locking solution in chronic hemodialysis patients. We compared catheter dysfunction episodes, dialysis adequacy, plasminogen-tissular activators use and costs according to catheter-locking solution in our centre. METHODS: Prospective, monocentric, cohort study (NephroCare Tassin-Charcot) on 49 prevalent patients in chronic hemodialysis. Two main groups were formed according to the prescription of catheter-locking solution at the beginning of the study (03/02/2016) and followed until 05/10/2016: heparin (n=26) and citrate (n=22)...
November 27, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29187653/-investigation-of-status-for-vascular-access-in-hemodialysis-patients-at-xiangya-hospital-of-central-south-university
#10
Yong Zhong, Jiaxi Pu, Xiang Ao, Weisheng Peng, Zhangzhe Peng, Xiaozhao Li, Xiangcheng Xiao, Qiaoling Zhou, Ping Xiao
To investigate the status of vascular access in hemodialysis patients in our center.
 Methods: The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016, were retrospectively analyzed.
 Results: Among 258 prevalent patients, 87.60% of them had arteriovenous fistula (AVF), while 12.40% showed tunneled cuffed catheter. Of the 61 incident patients, 80.33% of them initiated dialysis with a non-tunneled and non-cuffed catheter, 8...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29169160/the-use-of-peritoneal-dialysis-in-phenobarbitone-toxicity-in-a-critically-unwell-neonate
#11
Amelia K Le Page, Alice E Stewart, Charles C Roehr, Lilian M Johnstone, Andis Graudins
BACKGROUND: Phenobarbitone (PB) is the first-line anti-convulsant for neonatal seizures. The use of peritoneal dialysis (PD) to enhance drug elimination in cases of neonatal PB overdose has not been reported. OBJECTIVE: To report a case of neonatal severe PB toxicity and review the elimination of PB by PD. METHODS: Assessment of PD drug clearance. RESULTS: A neonate with prolonged seizures was administered PB. Encephalopathy and myocardial failure developed, which were initially suspected to be secondary to hypoxia...
November 24, 2017: Neonatology
https://www.readbyqxmd.com/read/29162681/clusters-of-practice-in-peritoneal-dialysis-in-france-data-from-the-catheter-section-of-the-rdplf
#12
Antoine Lanot, Clemence Bechade, Christian Verger, Emmanuel Fabre, Isabelle Vernier, Thierry Lobbedez
BACKGROUND: Peritonitis is a major cause of peritoneal dialysis (PD) failure. Recommendations for the prevention of peritonitis are available, but wide variations exist in the peritonitis rate among countries and PD units. The objective of this study was to describe the different pattern of practices in France. METHODS: This was a retrospective, multicenter study based on data from the French Language Peritoneal Dialysis Registry. Center practices were described and mapped...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29162678/stability-of-ceftazidime-and-heparin-in-four-different-types-of-peritoneal-dialysis-solutions
#13
Surendra Kandel, Syed Tabish R Zaidi, Troy Wanandy, Long Ming, Ronald Castelino, Kamal Sud, Rahul P Patel
BACKGROUND: Intraperitoneal (IP) administration of ceftazidime is recommended for the treatment of peritoneal dialysis-associated peritonitis (PDAP) from Pseudomonas. Patients with PDAP may also need IP heparin to overcome problems with drainage of turbid peritoneal dialysis (PD) fluids and blockage of catheters with fibrin. Physico-chemical stability of ceftazidime and heparin, and biological stability of heparin in many types of PD solutions is unknown. Therefore, we investigated the stability of ceftazidime and heparin in 4 types of PD solutions...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29162677/feasibility-of-urgent-start-peritoneal-dialysis-in-older-patients-with-end-stage-renal-disease-a-single-center-experience
#14
Haijiao Jin, Zhaohui Ni, Shan Mou, Renhua Lu, Wei Fang, Jiaying Huang, Chunhua Hu, Haifen Zhang, Hao Yan, Zhenyuan Li, Zanzhe Yu
BACKGROUND: Patients with end-stage renal disease (ESRD) frequently require urgent-start dialysis. Recent evidence suggests that peritoneal dialysis (PD) might be a feasible alternative to hemodialysis (HD) in these patients, including in older patients. METHODS: This retrospective study enrolled patients aged > 65 years with ESRD who underwent urgent dialysis without functional vascular access or PD catheter at a single center, from January 2011 to December 2014...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29161695/a-randomized-controlled-trial-of-comparing-ultrasound-guided-transversus-abdominis-plane-block-with-local-anesthetic-infiltration-in-peritoneal-dialysis-catheter-implantation
#15
Qi Li, Xiaohong Tang, Tian Tao, Wenjuan Zhang, Wei Qin, Jie Zhang, Zi Li
BACKGROUND: The ultrasound-guided transversus abdominis plane (TAP) block has been demonstrated as a useful analgesia technique in lower-abdomen surgeries. We hypothesized that it could be the principal anesthesia technique for end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD) catheter (PDC) implantation using the open dissection method. METHODS: This was a single-center, prospective, randomized, and double-blinded study. All eligible patients were randomized into 2 groups: the TAP block group (n = 20) and the local anesthetic infiltration (LAI) group (n = 20)...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29161686/impact-of-an-in-hospital-patient-education-program-on-choice-of-renal-replacement-modality-in-unplanned-dialysis-initiation
#16
Moritz Schanz, Markus Ketteler, Markus Heck, Juergen Dippon, Mark Dominik Alscher, Martin Kimmel
BACKGROUND/AIMS: Up to 50% patients requiring dialysis receive an urgent, unplanned start (UPS) to renal replacement therapy (RRT). Most of these are initiated with an intravenous catheter and commenced and maintained on hemodialysis (HD). Although peritoneal dialysis (PD) could be an equipotent initial modality for RRT, it is used less frequently as long-term RRT in UPS patients. This multicenter-study aimed to evaluate the impact of a structured, in-hospital education program and factors influencing PD rates, especially in UPS patients...
November 21, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29160975/peritoneal-dialysis-access-management-more-than-skin-deep
#17
Susan Bridger
Providing care and education for a patient on peritoneal dialysis (PD) requires that the nephrology nurse have knowledge and expertise in the PD access. This article provides information on types and placement of PD catheters, pre-placement and post-placement education and care, how to assess PD catheter exit site healing, and initial use of the PD catheter for access.
September 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29150711/epidemiology-of-peritonitis-following-maintenance-peritoneal-dialysis-catheter-placement-during-infancy-a-report-of-the-scope-collaborative
#18
Joshua Jacob Zaritsky, Coral Hanevold, Raymond Quigley, Troy Richardson, Cynthia Wong, Jennifer Ehrlich, John Lawlor, Jonathan Rodean, Alicia Neu, Bradley A Warady
BACKGROUND: Maintenance peritoneal dialysis (PD) is the dialysis modality of choice for infants and young children. However, there are limited outcome data for those who undergo PD catheter insertion and initiate maintenance PD within the first year of life. METHODS: Using data from the Children's Hospital Association's Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (ESRD) Collaborative (SCOPE), we examined peritonitis rates and patient survival in 156 infants from 29 North American pediatric dialysis centers who had a chronic PD catheter placed prior to their first birthday...
November 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#19
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/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#20
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
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