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Tunneled dialysis catheter

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https://www.readbyqxmd.com/read/28917008/peritoneal-dialysis-catheter-function-and-survival-are-not-adversely-affected-by-obesity-regardless-of-the-operative-technique-used
#1
Monika A Krezalek, Nicolas Bonamici, Kristine Kuchta, Brittany Lapin, JoAnn Carbray, Woody Denham, John Linn, Michael Ujiki, Stephen P Haggerty
BACKGROUND: Obesity has been considered a relative contraindication to peritoneal dialysis (PD). Surprisingly, PD catheter dysfunction rates and longevity have not been studied in the growing obese ESRD population. The aim of this study was to determine the effect of patient weight on PD catheter survival in the three insertion technique categories of advanced laparoscopy (AL), basic laparoscopy (BL), and open. METHODS: We examine retrospectively collected data on 231 consecutive PD catheter insertions at the NorthShore University HealthSystem between 2004 and 2014...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28899228/intraoperative-venoplasty-to-facilitate-placement-of-tunneled-catheters-for-hemodialysis
#2
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/28890326/taurolidine-based-catheter-lock-regimen-significantly-reduces-overall-costs-infection-and-dysfunction-rates-of-tunneled-hemodialysis-catheters
#3
Wolfgang Winnicki, Harald Herkner, Matthias Lorenz, Ammon Handisurya, Željko Kikić, Bernhard Bielesz, Benjamin Schairer, Thomas Reiter, Farsad Eskandary, Gere Sunder-Plassmann, Guerkan Sengoelge
Catheter-related infections and dysfunction are the main catheter complications causing morbidity and mortality in hemodialysis patients. However, there are no consistent data for the choice of catheter lock solutions for tunneled hemodialysis lines. In this prospective, multicenter, randomized, controlled trial, two lock regimens using three commercial catheter lock solutions were compared in 106 hemodialysis patients with a newly inserted tunneled central catheter. In the taurolidine group, TauroLock™-Hep500 was used twice per week and TauroLock™-U25,000 once a week...
September 7, 2017: Kidney International
https://www.readbyqxmd.com/read/28862725/longitudinal-dialysis-adequacy-and-clinical-performance-of-the-vectorflow-hemodialysis-catheter-a-prospective-study
#4
John R Ross, Tatiana A Puga, Thomas E Philbeck
PURPOSE: To report clinical performance and longitudinal assessment of hemodialysis adequacy with the Arrow-Clark VectorFlow catheter, a symmetrical-tip device with a distal lumen configuration designed to reduce platelet shear stress and catheter thrombosis. METHODS AND MATERIALS: We prospectively enrolled patients who required de novo placement of a chronic tunneled catheter for hemodialysis or exchange of a dysfunctional catheter as part of an Institutional Review Board (IRB)-approved protocol...
August 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28822665/the-associations-of-hemodialysis-access-type-and-access-satisfaction-with-health-related-quality-of-life
#5
Natalie Domenick Sridharan, Larry Fish, Lan Yu, Steven Weisbord, Manisha Jhamb, Michel S Makaroun, Theodore H Yuo
OBJECTIVE: In addition to age and comorbidities, health-related quality of life (HRQOL) is known to predict mortality in hemodialysis (HD) patients. Understanding the association of vascular access type with HRQOL can help surgeons to provide patient-centered dialysis access recommendations. We sought to understand the impact of HD access type on HRQOL. METHODS: We conducted a cross-sectional prospective study of community-dwelling prevalent HD patients in Pittsburgh, Pennsylvania...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28794295/foreign-body-reaction-to-dialysis-chatheter-and-peritoneal-fluid-eosinophilia-in-a-child-on-continuous-ambulatory-peritoneal-dialysis
#6
Nuran Cetin, Nadide Melike Sav, Evrim Ciftci, Bilal Yildiz
Foreign body reaction is a tissue response against implanted materials. We described for the first time the eosinophilic peritonitis and foreign body giant cell reaction to dialysis catheter in a nonatopic child on continuous ambulatory peritoneal dialysis. We found tenderness, redness, and swelling without purulent discharge around the peritoneal catheter; increased eosinophil count in cloudy dialysis fluid; and blood and hyperechoic granulomatous formation appearance surrounding the peritoneal catheter on ultrasonography and foreign body giant cell reaction to dialysis catheter in pathologic examination of granulomatous lesionin in our patient...
July 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28777407/management-of-hypertension-in-patients-during-percutaneous-dialysis-access-interventions
#7
Bhavika V Gandhi, Tejas B Patel, Eric J Costanzo, Avais Masud, Sushil Mehandru, Loay Salman
Not infrequently, interventionalists are faced with a patient with increased blood pressure who is about to undergo a dialysis access intervention such as tunneled hemodialysis catheter, percutaneous balloon angioplasty, or declotting procedure for a clotted arteriovenous access. This can frequently create a dilemma as functional dialysis access is needed to provide dialysis therapy and delaying treatment could result in a life-threatening situation, particularly in the presence of hyperkalemia. This article investigates hypertension in patients undergoing percutaneous dialysis access interventions and provides guidance to their management...
July 27, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28743653/a-review-of-arterio-venous-fistulae-creation-in-octogenarians
#8
Jennifer Clarissa Diandra, Zhiwen Joseph Lo, Wei-Wen Ang, Jue Fei Feng, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
BACKGROUND: To analyse the outcomes of arterio-venous fistulae (AVF) creation in Octogenarians. METHODS: Retrospective study of 47 AVFs created in patients aged 80 years and above from 2008 to 2014. Patient and AVF characteristics and outcomes were evaluated. Predictors of patency were analysed with multivariate analysis and Kaplan-Meier patency and survival analysis was performed. RESULTS: 47 of 1,259 AVFs created were for Octogenarians (4%)...
July 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28676515/peritoneal-dialysis-catheters-to-treat-refractory-non-malignant-ascites
#9
Jay Hingwala, Reid Whitlock, Sara Dunsmore, Sean Armstrong, Navdeep Tangri, Paul Komenda
Refractory non-malignant ascites is associated with significant morbidity. Serial, large-volume paracentesis is a common treatment. Tunneled peritoneal dialysis (PD) catheters are an effective treatment for refractory malignant ascites, but there are limited data on complications and effectiveness for non-malignant ascites. We reviewed all 13 PD catheter insertions between 2010 - 2015 for this indication at our center. The median catheter survival time was 146 days. No complications occurred during catheter insertion, and no mechanical complications occurred after catheter insertion...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28668967/anatomy-revisited-hemodialysis-catheter-malposition-in-the-left-ascending-lumbar-vein
#10
Stefan Büttner, Sammy Patyna, Sarah Rudolf, Despina Avaniadi, Moritz Kaup, Helmut Geiger, Christoph Betz
In selected cases, cuffed tunneled catheters via the iliac vein are implanted as a last resort access for hemodialysis. To monitor the correct position, sonography of the inferior vena cava (IVC) is sufficient in most cases. Position control using an X-ray of the abdomen is not routinely recommended when femoral catheters are implanted. In this report, we describe the case of a 59-year-old patient on chronic hemodialysis due to granulomatosis with polyangiitis and complex shunt history with multiple shunt occlusions and revisions...
July 1, 2017: Blood Purification
https://www.readbyqxmd.com/read/28665465/outcomes-of-a-nephrologist-driven-tunnelled-dialysis-catheter-insertion-service-in-south-east-asia
#11
Milind Nikam, Claude J Renaud, Joshua Shaowen Lee, Sri Fairuz B Saifful, Allen Yan Lun Liu, Eng Kuang Lim, Ying Ying Seow, Lee Ying Yeoh
INTRODUCTION: Tunnelled dialysis catheters (TDCs) are being increasingly inserted by nephrologists globally but there is limited experience and paucity of published outcomes data from South-East Asia (SEA). This study was conducted to analyse the outcomes of TDC insertion by nephrologists from a single centre in SEA. METHODS: All patients who underwent TDC insertion by nephrologists from October 2013 to June 2016 were included. TDC survival was calculated using Kaplan-Meier survival method...
July 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28638613/cuff-extrusion-in-peritoneal-dialysis-single-centre-experience-with-the-cuff-shaving-procedure-in-five-patients-over-a-4-year-period
#12
Jedrzej A Debowski, Cora Wærp, Stig A Kjellevold, Sadollah Abedini
Catheter-related infections in peritoneal dialysis (PD) remain a significant complication, and some patients with recurrent exit-site (ESI) and/or tunnel infections may experience external cuff extrusion. In these cases, cuff-shaving has been described as a possible course of treatment. During a 4-year period, there were 44 patients with PD at our department; all received double-cuffed Tenckhoff catheters. Six (13%) never started on PD. Five (13%) of the 38 active PD patients experienced cuff extrusion. Causes of end-stage renal disease (ESRD) were diabetic nephropathy (n = 1), toxic nephropathy (n = 1), hypertensive nephrosclerosis (n = 1), systemic disease (n = 1) and one with unknown cause...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28623638/urokinase-containing-locking-solution-in-the-prevention-of-dialysis-catheter-dysfunction-a-double-blind-randomized-controlled-trial
#13
Florence Bonkain, Freya Van Hulle, Peter Janssens, Concetta Catalano, Mandelina Allamani, Jean-Claude Stolear, Dominique Vandervelde, Mark Libertalis, Serge Treille, Marie M Couttenye, Annemie Dhondt, Wim Van Biesen, Jean François Fils, Christian Tielemans, Karl M Wissing
INTRODUCTION: The prophylactic use of recombinant tissue plasminogen activator once weekly reduces the incidence rate of tunneled cuffed catheter (TCC) malfunction and bacteremia as compared to the exclusive use of heparin as locking solution. Restricting the use of prophylactic thrombolytic agents to patients with a history of thrombotic TCC malfunction could be more cost effective. We conduct a multicenter, double-blind, randomized controlled trial and test the hypothesis that weekly use of urokinase lock will reduce the incidence of thrombotic malfunction by 50% in prevalent hemodialysis patients with a history of thrombotic malfunction...
June 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#14
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
2017: Nephron
https://www.readbyqxmd.com/read/28480823/clinical-course-of-hemodialysis-access-after-initial-endovascular-intervention-for-stenosis-in-asian-renal-failure-patients
#15
Dewahar Senthoor, Kyi Zin Thant, Tze-Kiat Ng, Pei Ho
BACKGROUND: Arteriovenous fistula (AVF) and arteriovenous fistula graft (AVG) access for hemodialysis can develop stenosis, eventually leading to thrombosis and access failure. Prompt endovascular intervention can salvage the access but restenosis does occur. Clinical course, restenosis pattern, and risk factors associated with initial stenosis of AVFs/AVGs in Asian hemodialysis patients were studied. METHOD: A retrospective study was conducted (January 2009-June 2012) on consecutive patients with renal failure who developed the first-time stenosis in the vascular access and were managed with endovascular intervention...
August 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28455661/modified-laparoscopic-placement-of-peritoneal-dialysis-catheter-with-intra-abdominal-fixation
#16
Quanquan Shen, Xinxin Jiang, Xiaogang Shen, Fangyan Yu, Qiudi Tu, Wangfang Chen, Qing Ye, Tapas Ranjan Behera, Qiang He
PURPOSE: Peritoneal dialysis (PD) is a commonly accepted method of treating end-stage renal disease (ESRD). Various laparoscopic techniques for the placement of PD catheter have been described. In this study, we developed a novel modified laparoscopic technique for PD catheter placement and evaluated the early results. METHODS: A straight Tenckhoff PD catheter was placed employing the modified technique in 39 consecutive patients with ESRD from May 2013 to April 2016...
August 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28445893/early-mortality-associated-with-inpatient-versus-outpatient-hemodialysis-initiation-in-a-large-cohort-of-us-veterans-with-incident-end-stage-renal-disease
#17
Faisal M Arif, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Jun Ling Lu, Fatima Hassan, Fridtjof Thomas, Omer A Siddiqui, Geeta G Gyamlani, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Mortality in the immediate post-hemodialysis transition period is extremely high. Many end-stage renal disease (ESRD) patients in the US start dialysis in an inpatient setting, but the characteristics of patients starting dialysis as inpatients, and the association of inpatient hemodialysis transition with mortality remain unclear. METHODS: We examined 48,261 US veterans who transitioned to hemodialysis between October 2007 and September 2011. Associations of inpatient hemodialysis starting with all-cause mortality were examined in Cox proportional hazard models, with adjustments for demographics, comorbidities, vascular access type, pre-dialysis nephrology care and medication use, and last pre-ESRD estimated glomerular filtration rate and hemoglobin...
2017: Nephron
https://www.readbyqxmd.com/read/28429519/the-incidence-and-costs-of-bacteremia-due-to-lack-of-gentamicin-lock-solutions-for-dialysis-catheters
#18
Tze Liang Goh, Jason Wei, David Semple, John Collins
The use of antibiotic lock solutions as prophylaxis for catheter-associated blood stream infection (CRBSI) has been shown to be effective in previous randomized controlled trials. However, the cost-effectiveness of this approach had not been studied. In 2012, the routine gentamicin-heparin lock solution used in Auckland City Hospital was withdrawn from the market, leading to a change to heparin-only lock. This was then replaced with gentamicin-citrate lock in 2014. This situation allowed review of the CRBSI rate and financial impact of different catheter lock solutions...
June 2017: Nephrology
https://www.readbyqxmd.com/read/28422870/case-report-the-first-case-of-achromobacter-xylosoxidans-related-tunnel-infection-in-a-patient-receiving-peritoneal-dialysis
#19
Jun-Li Tsai, Shang-Feng Tsai
RATIONALE: Achromobacter xylosoxidans infection is mostly reported in immunocompromised patients. Until now, it is still rarely reported in patients undergoing peritoneal dialysis. PATIENT CONCERNS: This is the 1st case of A xylosoxidans infection due to tunnel infection of a Tenckhoff catheter. DIAGNOSIS: The diagnosis was confirmed by the report of culture. INTERVENTIONS: Risk factors for this infection in peritoneal dialysis include uremia with an immunocompromised state, contamination due to inexperienced skills, and aqueous environment of the dialysate...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420654/changes-in-the-profile-of-endovascular-procedures-performed-in-freestanding-dialysis-access-centers-over-15-years
#20
Gerald A Beathard, Aris Urbanes, Terry Litchfield
BACKGROUND AND OBJECTIVES: Marked changes occurred in the vascular access profile of patients receiving hemodialysis in the United States over the 15-year period of 2001-2015. This study was undertaken to evaluate how these changes have affected dialysis access maintenance and salvage procedures performed in freestanding dialysis access centers and to examine the effectiveness, efficiency, and safety of these procedures in this setting. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were collected from freestanding, dedicated dialysis access centers operating under a common system of management...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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