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https://www.readbyqxmd.com/read/29319771/peritoneal-dialysis-as-the-first-dialysis-treatment-option-initially-unplanned
#1
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29318218/potential-benefit-associated-with-delaying-initiation-of-hemodialysis-in-a-japanese-cohort
#2
Satoshi Higuchi, Izaya Nakaya, Kazuhiro Yoshikawa, Yoichiro Chikamatsu, Ken-Ei Sada, Suguru Yamamoto, Satoko Takahashi, Hiroyo Sasaki, Jun Soma
Introduction: Late referral to a nephrologist, the type of vascular access, nutritional status, and the estimated glomerular filtration rate (eGFR) at the start of hemodialysis (HD) have been reported as independent risk factors of survival for patients who begin HD. The aim of this study was to clarify the influence of the HD-free interval from the time of an eGFR of 10 ml/min per 1.73 m2 (IGFR10-HD) on patient outcome. Methods: We enrolled 124 patients aged older than 20 years who had HD initiated in a general hospital...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29301135/a-retrospective-analysis-of-dialysis-events-over-a-3-year-period-in-an-outpatient-dialysis-unit-in-the-state-of-kuwait
#3
Moustapha Ramadan, Gautam Hebbar
OBJECTIVE: To determine the difference in the rates of dialysis events stratified by vascular access type and to describe the microbiological profile and sensitivity patterns of positive blood cultures over a 3-year period. SUBJECTS AND METHODS: The dialysis event data of 10751 chronic hemodialysis patients collected from March 2013 to February 2016 at an Outpatient Dialysis Unit in Kuwait were reviewed. The dialysis events studied were; use of intravenous (IV) antimicrobials, positive blood culture and signs of inflammation at the vascular access site...
January 4, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29285424/maturation-of-arteriovenous-fistula-analysis-of-key-factors
#4
REVIEW
Muhammad A Siddiqui, Suhel Ashraff, Thomas Carline
The growing proportion of individuals suffering from chronic kidney disease has considerable repercussions for both kidney specialists and primary care. Progressive and permanent renal failure is most frequently treated with hemodialysis. The efficiency of hemodialysis treatment relies on the functional status of vascular access. Determining the type of vascular access has prime significance for maximizing successful maturation of a fistula and avoiding surgical revision. Despite the frequency of arteriovenous fistula procedures, there are no consistent criteria applied before creation of arteriovenous fistulae...
December 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29275056/the-pivotal-multicenter-trial-of-ultrasound-guided-percutaneous-arteriovenous-fistula-creation-for-hemodialysis-access
#5
Jeffrey E Hull, William C Jennings, Randy I Cooper, Umar Waheed, Matthew E Schaefer, Rajeev Narayan
PURPOSE: To evaluate safety and efficacy of arteriovenous fistulas (AVFs) created with a thermal resistance anastomosis device. MATERIALS AND METHODS: A prospective single-arm trial at 5 sites enrolled 107 patients. Patients underwent ultrasound (US)-guided anastomosis creation between the proximal radial artery and perforating vein with the Ellipsys Vascular Access System (Avenu Medical, Inc, San Juan Capistrano, California) followed by separate maturation procedures...
December 21, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#6
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
December 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29212839/bp-in-dialysis-results-of-a-pilot-study
#7
Dana C Miskulin, Jennifer Gassman, Ronald Schrader, Ambreen Gul, Manisha Jhamb, David W Ploth, Lavinia Negrea, Raymond Y Kwong, Andrew S Levey, Ajay K Singh, Antonia Harford, Susan Paine, Cynthia Kendrick, Mahboob Rahman, Philip Zager
The optimal BP target for patients receiving hemodialysis is unknown. We randomized 126 hypertensive patients on hemodialysis to a standardized predialysis systolic BP of 110-140 mmHg (intensive arm) or 155-165 mmHg (standard arm). The primary objectives were to assess feasibility and safety and inform the design of a full-scale trial. A secondary objective was to assess changes in left ventricular mass. Median follow-up was 365 days. In the standard arm, the 2-week moving average systolic BP did not change significantly during the intervention period, but in the intensive arm, systolic BP decreased from 160 mmHg at baseline to 143 mmHg at 4...
January 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29210176/online-measurement-of-hemodialysis-adequacy-using-effective-ionic-dialysance-of-sodium-a-review-of-its-principles-applications-benefits-and-risks
#8
REVIEW
Shakil Aslam, Subodh J Saggi, Moro Salifu, Robert J Kossmann
Dialysis dose is an important determinant of clinical outcomes in patients with end stage renal disease on maintenance dialysis. In clinical practice dialysis dose is monitored at least monthly by urea clearance based on Urea Kinetic Modeling. Online clearance monitoring using effective ionic dialysance (EID) of sodium (Na+ ) is available on some hemodialysis machines. This paper reviews the background, methodology, additional applications, and potential risks associated with EID. Effective ionic dialysance provides a reliable, real-time, noninvasive, and inexpensive measurement of dialysis dose during an ongoing hemodialysis (HD) session to allow interventions and assess the impact of these changes on clearance...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29210164/relative-risk-of-home-hemodialysis-attrition-in-patients-using-a-telehealth-platform
#9
Eric D Weinhandl, Allan J Collins
INTRODUCTION: Home hemodialysis (HHD) facilitates increased treatment frequency, which may improve patient outcomes. However, attrition due to technique failure limits the clinical effectiveness of the modality. Nx2me Connected Health is a telehealth platform that enables ongoing assessment of HHD patients using NxStage equipment, and that may reduce patient burden. We aimed to assess whether use of Nx2me was associated with risk of HHD attrition. METHODS: We compared risks of all-cause attrition, dialysis cessation (i...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29203125/vascular-access-outcomes-reported-in-maintenance-hemodialysis-trials-a-systematic-review
#10
Andrea K Viecelli, Emma O'Lone, Benedicte Sautenet, Jonathan C Craig, Allison Tong, Eric Chemla, Lai-Seong Hooi, Timmy Lee, Charmaine Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Ashley B Irish, Trevor A Mori, Elaine M Pascoe, David W Johnson, Carmel M Hawley
BACKGROUND: Many randomized controlled trials have been performed with the goal of improving outcomes related to hemodialysis vascular access. If the reported outcomes are relevant and measured consistently to allow comparison of interventions across trials, such trials can inform decision making. This study aimed to assess the scope and consistency of vascular access outcomes reported in contemporary hemodialysis trials. STUDY DESIGN: Systematic review. SETTING & POPULATION: Adults requiring maintenance hemodialysis...
December 1, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29202728/non-tunneled-versus-tunneled-dialysis-catheters-for-acute-kidney-injury-requiring-renal-replacement-therapy-a-prospective-cohort-study
#11
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/29198387/international-differences-in-the-location-and-use-of-arteriovenous-accesses-created-for-hemodialysis-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#12
Ronald L Pisoni, Lindsay Zepel, Richard Fluck, Charmaine E Lok, Hideki Kawanishi, Gültekin Süleymanlar, Haimanot Wasse, Francesca Tentori, Jarcy Zee, Yun Li, Douglas Schaubel, Steven Burke, Bruce Robinson
BACKGROUND: Vascular access practice is strongly associated with clinical outcomes. There is substantial international variation in the use of arteriovenous fistulas (AVFs) and grafts (AVGs), as well as AVF maturation time and location. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Hemodialysis patients participating in the prospective Dialysis Outcomes and Practice Patterns Study (DOPPS) from the United States, Japan, and Europe/ANZ (Belgium, France, Germany, Italy, Spain, Sweden, United Kingdom, Australia, and New Zealand), including 3,850 patients receiving 4,247 new AVFs and 842 patients receiving 1,129 new AVGs in 2009 to 2015...
November 29, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29188361/disruptive-technological-advances-in-vascular-access-for-dialysis-an-overview
#13
REVIEW
Wee-Song Yeo, Qin Xiang Ng
End-stage kidney disease (ESKD), one of the most prevalent diseases in the world and with increasing incidence, is associated with significant morbidity and mortality. Current available modes of renal replacement therapy (RRT) include dialysis and renal transplantation. Though renal transplantation is the preferred and ideal mode of RRT, this modality may not be available to all patients with ESKD. Moreover, renal transplant recipients are constantly at risk of complications associated with immunosuppression and immunosuppressant use, and posttransplant lymphoproliferative disorder...
November 29, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29188313/arteriovenous-fistula-maturation-failure-in-a-large-cohort-of-hemodialysis-patients-in-the-netherlands
#14
Bram M Voorzaat, Koen E A van der Bogt, Cynthia J Janmaat, Jan van Schaik, Friedo W Dekker, Joris I Rotmans
OBJECTIVES: Radiocephalic arteriovenous fistulas (RCAVF) are the preferred vascular access (VA) for hemodialysis (HD). Cohort studies from North America revealed that nonmaturation is a significant disadvantage of RCAVFs compared to other VAs. DESIGN: This present retrospective study describes the incidence of nonmaturation of AVFs and functional failure of arteriovenous grafts (AVG) in a multicentre cohort in the Netherlands and attempts to create a prediction model for nonmaturation of RCAVFs...
November 29, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29187653/-investigation-of-status-for-vascular-access-in-hemodialysis-patients-at-xiangya-hospital-of-central-south-university
#15
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/29186549/intradialytic-hypertension-is-associated-with-low-intradialytic-arterial-oxygen-saturation
#16
Anna Meyring-Wösten, Ya Luo, Hanjie Zhang, Priscila Preciado, Stephan Thijssen, Yuedong Wang, Peter Kotanko
Background: The pathophysiology of a paradoxical systolic blood pressure (SBP) rise during hemodialysis (HD) is not yet fully understood. Recent research indicated that 10% of chronic HD patients suffer from prolonged intradialytic hypoxemia. Since hypoxemia induces a sympathetic response we entertained the hypothesis that peridialytic SBP change is associated with arterial oxygen saturation (SaO 2 ). Methods: We retrospectively analyzed intradialytic SaO 2 and peridialytic SBP change in chronic HD patients with arteriovenous vascular access...
November 24, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29185127/patient-knowledge-and-adherence-to-maintenance-hemodialysis-an-international-comparison-study
#17
Kana N Miyata, Jenny I Shen, Yasuhide Nishio, Manabu Haneda, Kobena A Dadzie, Nijal R Sheth, Renjiro Kuriyama, Chika Matsuzawa, Ken Tachibana, Nikolas B Harbord, James F Winchester
BACKGROUND: Non-adherence to hemodialysis (HD) is associated with increased morbidity and mortality. In this cross-sectional study, we compared correlates and rates of non-adherence between the US and Japan to determine if differences in patient knowledge about HD might account for international variation in adherence. METHODS: We evaluated 100 US and 116 Japanese patients on maintenance HD. Patient knowledge was scored based on the identification of their vascular access, dry weight, cause of kidney disease, and ≥ 3 phosphorus- and potassium-rich foods...
November 28, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29178510/the-pathogenesis-of-hemodialysis-vascular-access-failure-and-systemic-therapies-for-its-prevention-optimism-unfulfilled
#18
REVIEW
Andrea K Viecelli, Trevor A Mori, Prabir Roy-Chaudhury, Kevan R Polkinghorne, Carmel M Hawley, David W Johnson, Elaine M Pascoe, Ashley B Irish
In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are essential. Inadequate vascular remodeling and neointimal hyperplasia resulting in stenosis and frequently thrombosis are critical to the pathogenesis of access failure. Systemic medical therapies with pleiotropic effects including antiplatelet agents, omega-3 polyunsaturated fatty acids (fish oils), statins, and inhibitors of the renin-angiotensin-aldosterone system (RAAS) may reduce vascular access failure by promoting vascular access maturation and reducing stenosis and thrombosis through antiproliferative, antiaggregatory, anti-inflammatory and vasodilatory effects...
November 26, 2017: Seminars in 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
#19
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/29160969/nursing-care-for-patients-with-biological-arteriovenous-grafts
#20
Michelle Gilliland, Billie Axley
Patients receiving hemodialysis are challenged with maintaining adequate vascular access. Nephrology nurses are on the forefront of daily care, assessment, and monitoring of patients' vascular accesses for hemodialysis. This article discusses the literature and manufacturer information to support best nursing practices.
July 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
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