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https://www.readbyqxmd.com/read/28429519/the-incidence-and-costs-of-bacteremia-due-to-lack-of-gentamicin-lock-solutions-for-dialysis-catheters
#1
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 In 2012, the routine gentamicin-heparin lock solution used in Auckland City Hospital was withdrawn from the market, leading to a change to heparin-only lock.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
#2
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
#3
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...
April 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28407882/tunneled-dialysis-catheters-might-receive-permanent-resident-status-after-a-while-a-case-for-caution
#4
Abhilash Koratala, Volodymyr Chornyy, Ashutosh M Shukla, Amir Kazory
No abstract text is available yet for this article.
May 2017: Kidney International
https://www.readbyqxmd.com/read/28390069/antimicrobial-agents-for-preventing-peritonitis-in-peritoneal-dialysis-patients
#5
REVIEW
Denise Campbell, David W Mudge, Jonathan C Craig, David W Johnson, Allison Tong, Giovanni Fm Strippoli
BACKGROUND: Peritoneal dialysis (PD) is an important therapy for patients with end-stage kidney disease and is used in more than 200,000 such patients globally. However, its value is often limited by the development of infections such as peritonitis and exit-site and tunnel infections. Multiple strategies have been developed to reduce the risk of peritonitis including antibiotics, topical disinfectants to the exit site and antifungal agents. However, the effectiveness of these strategies has been variable and are based on a small number of randomised controlled trials (RCTs)...
April 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28360371/capd-catheter-exit-site-and-tunnel-infection-with-fungal-etiology-treatment-and-catheter-reinsertion-for-an-extremely-rare-complication
#6
Manmeet Singh Jhawar, Jasmin Das, Pratish George, Anil Luther
Fungal infection is an extremely rare etiology of exit-site and tunnel infection in patients on continuous ambulatory peritoneal dialysis (CAPD). There are few data available regarding its management-especially choice of antifungals, duration of therapy, and removal of catheter. There are no guidelines pertaining to reinsertion of the CAPD catheter following fungal exit-site and tunnel infection. This case report highlights Candida albicans as a rare cause of exit-site and tunnel infection of the CAPD catheter...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28355402/budd-chiari-syndrome-secondary-to-catheter-associated-inferior-vena-cava-thrombosis
#7
Gustavo N Araujo, Luciane M Restelatto, Carlos A Prompt, Cristina Karohl
INTRODUCTION: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. CASE REPORT: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28353491/nonprogrammed-vascular-access-is-associated-with-greater-mortality-in-patients-who-return-to-hemodialysis-with-a-failing-renal-graft
#8
Gustavo Laham, Gervasio Soler Pujol, Antonio Vilches, Ana Cusumano, Carlos Diaz
BACKGROUND: In incident hemodialysis (HD) patients the use of catheters is associated with a worse prognosis when compared to those with an arteriovenous fistula (AVF), but the role of vascular access (VA) type in the morbidity and mortality of patients returning to HD with a failing renal allograft is unknown. We aimed to determine the associations between the type of vascular access and mortality in this population. METHODS: This was a retrospective observational cohort study of 138 patients who initiated dialysis after kidney transplant failure between 1995 and 2014...
March 28, 2017: Transplantation
https://www.readbyqxmd.com/read/28279404/strategies-for-hemodialysis-access-a-vascular-surgeon-s-perspective
#9
Larry A Scher, Saadat Shariff
Problems related to hemodialysis access are a significant cause of morbidity and mortality in patients with end-stage renal disease. Physicians of all specialties who are involved in the placement and maintenance of vascular access for hemodialysis must have a long-term strategy for sequential placement of autogenous fistulas, transpositions, and prosthetic grafts to preserve access sites and to avoid long-term use of tunneled dialysis catheters. The Fistula First and KDOQI initiatives have provided strategies and algorithms for access placement in patients with chronic kidney disease...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28122398/comparison-between-types-of-dressing-following-catheter-insertion-and-early-exit-site-infection-in-peritoneal-dialysis
#10
Ana Elizabeth Figueiredo, Carolina de Mattos, Cristine Saraiva, Marcia Olandoski, Pasqual Barretti, Roberto Pecoits Filho, Thyago Proença de Moraes
AIM: To investigate whether the type of dressing used (occlusive vs semi-occlusive) impacts on exit-site infection (ESI). BACKGROUND: Exit-site infections are a major predisposing factor for peritoneal dialysis (PD)-related peritonitis, the main cause of technique failure and an important cause of mortality. Care taken in exit-site dressing is considered an important procedure for the prevention of trauma and contamination of this area. Nevertheless, to our knowledge, no study has yet analyzed the impact of different dressing types on early ESI (up to 2 months after catheter insertion)...
January 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28025835/bedside-tunneled-dialysis-catheter-removal-a-lesson-learned-from-nephrology-trainees
#11
REVIEW
Tibor Fülöp, Mihály B Tapolyai, Mohit Agarwal, Arnaldo Lopez-Ruiz, Miklos Z Molnar, Neville R Dossabhoy
Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27903856/laparoscopic-left-hemicolectomy-for-colon-cancer-in-peritoneal-dialysis-patients-a-valid-and-safe-surgical-technique-to-ensure-peritoneal-dialysis-survival
#12
Sara Auricchio, Giulio Mari, Andrea Galassi, Beatrice Dozio, Marco Pozzi, Dario Maggioni, Renzo Scanziani
A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27899416/peritoneal-dialysis-access-revision-in-children-causes-interventions-and-outcomes
#13
Dagmara Borzych-Duzalka, T Fazil Aki, Marta Azocar, Colin White, Elizabeth Harvey, Sevgi Mir, Marta Adragna, Erkin Serdaroglu, Rajiv Sinha, Charlotte Samaille, Juan Jose Vanegas, Jameela Kari, Lorena Barbosa, Arvind Bagga, Monica Galanti, Onder Yavascan, Giovanna Leozappa, Maria Szczepanska, Karel Vondrak, Kei-Chiu Tse, Franz Schaefer, Bradley A Warady
BACKGROUND AND OBJECTIVES: Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27891387/continuous-ambulatory-peritoneal-dialysis-catheter-tunnel-breakdown-and-its-repair
#14
Shantajit Nameirakpam, Salinita Naorem, Chetan Maibam, Sharatkumar Singh Naorem
No abstract text is available yet for this article.
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27886362/balloon-assisted-venous-access-salvage-through-a-thrombosed-arteriovenous-graft
#15
Chen Pong Wong, Karthikeyan Damodharan, Thijs A J Urlings, Sivanathan Chandramohan
INTRODUCTION: Maintaining vascular access by means of radiological intervention has become the mainstay of management of patients with central venous stenoses and occlusions (CVO), which can be challenging. We present a case of balloon-assisted percutaneous puncture of an occluded left subclavian vein, through a thrombosed arteriovenous graft, for a tunneled dialysis catheter insertion. METHODS: A thrombosed left arm arteriovenous graft was accessed, and the occluded left subclavian vein was traversed with 0...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#16
C Petridis, M Nitschke, W Lehne, E Smith, J P Goltz, H Lehnert, M Meier
OBJECTIVE/BACKGROUND: Central venous tunnelled hemodialysis catheters (CVTC) are used for initial vascular access in patients with renal failure. Tip design of the CVTC may play an important role in catheter function and complication rates, influencing adequate hemodialysis treatment of these patients. METHODS: This prospective, observational cohort study compared the function and complication rates of two CVTCs in patients with end stage renal disease (ESRD) within a follow-up period of 24 months...
November 19, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27876356/-low-flux-dialysate-daily-home-hemodialysis-a-result-for-the-62%C3%A2-first-french-and-belgian-patients
#17
Anaïs Benabed, Patrick Henri, Thierry Lobbedez, Eric Goffin, Simona Baluta, Abdelkader Benziane, Ahmed Rachi, Johan W van der Pijl, Clémence Bechade, Maxence Ficheux
Since 2011, a new device is available for low flux dialysate quotidian home hemodialysis in France and Belgium. This study aims to evaluate the characteristics and dialysis prescriptions for Nx Stage System One™ users. We retrospectively included patients trained between 2011 and 2013 in France and Belgium. We collected data concerning their clinical features, their dialysis prescriptions, their laboratory parameters until 6 months of dialysis and, reason for dropping in case of cessation. Sixty-two patients from 31 centers, aged 48±18 years old, with a sex ratio 46/16 (M/F) are included with a median Charlson comorbidity index of 1 [0-3]...
November 18, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27875815/wang-s-forceps-assisted-catheter-reposition-and-fixation-an-easy-and-reliable-rescue-method
#18
Huiming Wang, Yujuan Wang, Xinghua Chen, Jili Zhu
Catheter migration and omental wrap are the most common causes of catheter malfunction, which usually result in catheter removal or replacement. The conventional open surgery for catheter reposition has many disadvantages. A new tunnel is needed throughout the procedure of catheter replacement causing more pain and frustration to the patients. Another drawback is that the incidence of catheter migration after conventional catheter reposition surgery is still as high as it was before the procedure. Wang's forceps, an instrument commonly used in our peritoneal dialysis center, is easy and effective in catheter insertion and fixation...
2017: Blood Purification
https://www.readbyqxmd.com/read/27862718/peritoneal-catheter-fixation-combined-with-straight-upward-tunnel-and-low-implant-position-to-prevent-catheter-malfunction
#19
Qingyan Zhang, Chunming Jiang, Wei Zhu, Cheng Sun, Yangyang Xia, Tianfeng Tang, Cheng Wan, Qiuyuan Shao, Jing Liu, Bo Jin, Miao Zhang
AIM: Catheter malfunction is the main reason for early peritoneal dialysis (PD) technique failure. This study aimed to evaluate the effect of a new surgery technique with catheter fixation to the lower abdominal wall combined with straight upward tunnel and low implant position in reducing catheter malfunction. METHODS: Patients with end stage renal disease who received PD in our center from January 2013 to December 2015 were involved in this study. They were randomly divided into 3 groups according to surgical technique: traditional open surgery group, modified open surgery group and modified open surgery with catheter fixation group...
November 16, 2016: Nephrology
https://www.readbyqxmd.com/read/27834456/over-catheter-tract-suture-to-prevent-bleeding-and-air-embolism-after-tunnelled-catheter-removal
#20
Krzysztof Letachowicz, Tomasz Gołębiowski, Mariusz Kusztal, Jan Penar, Waldemar Letachowicz, Wacław Weyde, Marian Klinger
INTRODUCTION: Severe, life-threating, complications might occur on dialysis catheter removal. METHODS: We present a useful technique that may prevent vascular air embolism and severe bleeding. RESULTS: The suture is placed around the catheter and tied over previous tract just after device removal. CONCLUSIONS: Applying a compressing suture to the tract left after removal of a tunnelled haemodialysis catheter is a simple manoeuvre that could prevent severe complication...
November 8, 2016: Journal of Vascular Access
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