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hemodialysis vascular access

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https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#1
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27911460/retrospective-comparison-of-two-different-approaches-for-ultrasound-guided-internal-jugular-vein-cannulation-in-hemodialysis-patients
#2
Antonio Treglia, Dario Musone, Francesco Amoroso
BACKGROUND: Prevalent hemodialysis patients with vascular access consisting of a central venous catheter (CVC) are continuously increasing over the years. Improvement in evolution and CVC placement procedures represents therefore an essential tool to enhance performance and reduce intraoperative and long-term CVC complications. Internal jugular vein (IJV) catheterization techniques are different according to ultrasound probe position in relation to vein axis and to needle direction in relation to ultrasound beam...
December 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#3
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27903996/survival-of-patients-on-hemodialysis-and-predictors-of-mortality-a-single-centre-analysis-of-time-dependent-factors
#4
Shahrzad Ossareh, Farhat Farrokhi, Marjan Zebarjadi
INTRODUCTION: This study aimed to evaluate the outcome and predictors of survival in hemodialysis patients of Hasheminejad Kidney Center where a comprehensive dialysis care program has been placed since 2004. MATERIALS AND METHODS: Data of 560 hemodialysis patients were used to evaluate 9-year survival rates and predictors of mortality. Cox regression models included comorbidities as well as averaged and 6-month-averaged time-dependent values of laboratory findings as independent factors...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27903478/the-clinical-efficacy-of-balloon-assisted-maturation-of-autogenous-arteriovenous-fistulae
#5
Syed Ali Rizvi, Fred Usoh, Anil Hingorani, Eleanor Iadgarova, Pamela Boniscavage, Justin Eisenberg, Enrico Ascher, Natalie Marks
OBJECTIVE: Delayed maturation of arteriovenous fistulae (AVF) among patients who require hemodialysis (HD) can lead to catheter sepsis with its resultant morbidity and mortality. Some have proposed that sequential balloon-assisted maturation (BAM) may accelerate the maturation times of these accesses. On the other hand, serial balloon angioplasty of normal vein may result in stenosis and delay maturation. Although the safety of BAM has been shown, direct comparison to non-matured AVF has not been explored...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27886366/utility-of-blind-percutaneous-jugular-venous-cannulation-in-resource-limited-settings
#6
Opeyemi Komolafe, Olalekan Olatise
BACKGROUND: For the nephrologist practicing in resource-limited settings, vascular ultrasound is often unavailable; consequently, blind percutaneous puncture of large veins is often employed to establish vascular access for hemodialysis. METHODS: To examine the efficacy and safety of this approach we evaluated 53 consecutive patients in whom central vascular access was required. The vascular access route utilized was primarily the right internal jugular vein. In the majority of cases, the indication for central vascular access was hemodialysis...
November 14, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#7
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/27868336/vascular-imaging-for-hemodialysis-vascular-access-planning
#8
Rita L McGill, Robin Ruthazer, Eduardo Lacson, Klemens B Meyer, Dana C Miskulin, Daniel E Weiner
Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010-2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time-dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#9
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27846776/infective-spondylodiscitis-in-patients-on-maintenance-hemodialysis-a-case-series
#10
Yueh-An Lu, Hsiang-Hao Hsu, Huang-Kai Kao, Chia-Hui Lee, Shen-Yang Lee, Guan-Hsing Chen, Cheng-Chieh Hung, Ya-Chung Tian
Infective spondylodiscitis is a rare disease. This case review describes the clinical course, risk factors, and outcomes of adult patients on maintenance hemodialysis who presented with infective spondylodiscitis at a single medical center in Taiwan. There were 18 cases (mean age: 64.9 ± 10.8 years) over more than 10 years. Analysis of underlying diseases indicated that 50% of patients had diabetes, 55.6% had hypertension, 55.6% had coronary artery disease, 22.2% had congestive heart failure, 22.2% had a cerebral vascular accident, 16...
November 16, 2016: Renal Failure
https://www.readbyqxmd.com/read/27832203/angiotensin-converting-enzyme-inhibitors-angiotensin-receptor-blockers-and-calcium-channel-blockers-are-associated-with-prolonged-vascular-access-patency-in-uremic-patients-undergoing-hemodialysis
#11
Fu-An Chen, Chih-Chiang Chien, Yu-Wei Chen, Yu-Te Wu, Chih-Ching Lin
BACKGROUND: Vascular access failure is a huge burden for patients undergoing hemodialysis. Many efforts have been made to maintain vascular access patency, including pharmacotherapy. Angiotensin converting enzyme inhibitor (ACE-I), angiotensin receptor blocker (ARB), and calcium channel blocker (CCB) are known for their antihypertensive and cardio-protective effects, however, their effects on long-term vascular access patency are still inconclusive. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We retrospectively enrolled patients commencing maintenance hemodialysis between January 1, 2000, and December 31, 2006 by using National Health Insurance Research Database in Taiwan...
2016: PloS One
https://www.readbyqxmd.com/read/27831511/diagnosis-treatment-and-prevention-of-hemodialysis-emergencies
#12
REVIEW
Manish Saha, Michael Allon
Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies...
November 9, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27824950/urgent-start-peritoneal-dialysis-and-hemodialysis-in-esrd-patients-complications-and-outcomes
#13
Haijiao Jin, Wei Fang, Mingli Zhu, Zanzhe Yu, Yan Fang, Hao Yan, Minfang Zhang, Qin Wang, Xiajing Che, Yuanyuan Xie, Jiaying Huang, Chunhua Hu, Haifen Zhang, Shan Mou, Zhaohui Ni
BACKGROUND: Several studies have suggested that urgent-start peritoneal dialysis (PD) is a feasible alternative to hemodialysis (HD) in patients with end-stage renal disease (ESRD), but the impact of the dialysis modality on outcome, especially on short-term complications, in urgent-start dialysis has not been directly evaluated. The aim of the current study was to compare the complications and outcomes of PD and HD in urgent-start dialysis ESRD patients. METHODS: In this retrospective study, ESRD patients who initiated dialysis urgently without a pre-established functional vascular access or PD catheter at a single center from January 2013 to December 2014 were included...
2016: PloS One
https://www.readbyqxmd.com/read/27819399/cytomegalovirus-encephalitis-in-a-hemodialysis-patient-a-rare-association
#14
Alberto Vera, Pablo Ruano, Esther Ortega, Borja Quiroga
Haemodialysis patients are at greater risk of infections than individuals not on dialysis due to their immunosuppressive state caused by several factors (uraemia, vascular access, inflammation, malnutrition). However, infections affecting the central nervous system are not frequent in this population. We present the case of a 77-year-old man with end-stage renal disease who was admitted to the emergency department for a decreased level of consciousness and fever. Although the initial clinical suspicion oriented to a urinary infection, the lack of improvement forced us to perform a lumbar puncture...
November 7, 2016: New Microbiologica
https://www.readbyqxmd.com/read/27795630/high-hemodialysis-vascular-access-flow-and-impaired-right-ventricular-function-in-chronic-hemodialysis-patients
#15
S Yilmaz, M Yetim, B K Yilmaz, T Dogan, E Aksoy, N Yuksel, I Dogan
There are limited data showing right ventricular preload increase due to high-flow arteriovenous fistulas (AVFs). This cross-sectional study investigated whether high AVF flow had an impact on right ventricular function in patients undergoing hemodialysis. Sixty-four patients aged between 18 and 85 years who were on routine hemodialysis with >2 hemodialysis sessions per week for at least 3 months via an AVF were studied. Patients with inadequate flow fistulas, severe chronic obstructive pulmonary disease, history of pulmonary embolism, primary pulmonary hypertension, severe mitral, aortic or pulmonary regurgitation, and/or stenosis were excluded...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27793271/non-imaging-assisted-insertion-of-un-cuffed-non-tunneled-internal-jugular-venous-catheters-for-hemodialysis-safety-and-utility-in-modern-day-world
#16
COMMENT
Manish Rathi, Venkata Siva Tez Pinnamaneni, Vinay Sakhuja
BACKGROUND: Absolute necessity in acute kidney injury (AKI) and ignorance in chronic kidney disease (CKD) make the use of un-cuffed, non-tunneled catheters an indispensable vascular access for hemodialysis. Although these catheters should be inserted under radiological guidance, it may not be feasible in certain circumstances. The aim of the present study was to evaluate safety and outcome of non-imaging assisted insertion of these catheters in internal jugular vein (IJV) for hemodialysis...
August 2016: Biomedical Journal
https://www.readbyqxmd.com/read/27791257/assessing-radiocephalic-wrist-arteriovenous-fistulas-of-obtuse-anastomosis-using-computational-fluid-dynamics-and-clinical-application
#17
Jinkee Lee, Sunho Kim, Sung-Min Kim, Ryungeun Song, Hyun Kyu Kim, Jang Sang Park, Sun Cheol Park
INTRODUCTION: A radiocephalic arteriovenous fistula (AVF) is the best choice for achieving vascular access (VA) for hemodialysis, but this AVF has high rates of early failure due to juxta-anastomotic stenosis, making it impossible to use for dialysis. Low hemodynamic shear stress contributes to the pathophysiology of VA failure due to secondary thrombosis, stenosis, and re-occlusion after percutaneous intervention. METHODS: We used a computational fluid dynamics (CFDs) approach to evaluate the shear stress distribution and minimize its effects under various conditions including changes in the anastomosis angle...
November 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27791255/hemodialysis-vascular-access-and-clinical-outcomes-an-observational-multicenter-study
#18
Tayebeh Soleymanian, Vida Sheikh, Faezeh Tareh, Hassan Argani, Shahrzad Ossareh
BACKGROUND: Arteriovenous fistula (AVF) is the optimal vascular access in hemodialysis (HD) patients because of its lower complication rates and better longevity compared to arteriovenous graft (AVG) and central venous catheter (CVC). METHODS: A cohort of 532 HD patients from nine HD facilities were recruited in September 2012 and prospectively followed for a median of 28 months. Unadjusted and fully adjusted hazard ratios (HR) of mortality for vascular access were calculated using Cox proportional hazards model...
October 26, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27786416/does-guidewire-exchange-influence-infection-rate-related-to-catheters-used-for-vascular-access-in-children-on-chronic-hemodialysis
#19
Rina R Rus, Nina Battelino, Rafael Ponikvar, Vladimir Premru, Gregor Novljan
A central venous catheter (CVC) can either be inserted "de novo" or placed by guidewire exchange (GWE). From September 1998 to September 2015, 32 children (19 boys, 13 girls) were hemodialyzed in our unit by using a CVC. The mean age at CVC insertion was 12.6 ± 0.5 years. A total of 121 uncuffed catheters were placed, either "de novo" or by GWE in 64 (52.9%) and 57 (47.1%) cases, respectively. The most frequent cause for line revision was catheter dysfunction in 40/121 (33.1%) patients. The overall incidence of bacteremia was 1...
October 27, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27781373/home-hemodialysis-associated-infection-the-achilles-heel-of-intensive-hemodialysis
#20
REVIEW
Clara K Poon, Christopher T Chan
Home hemodialysis (HHD) is emerging as an important alternate renal replacement therapy. Although there are multiple clinical advantages with HHD, concerns surrounding increased risks of infection in this group of patients remain a major barrier to its implementation. In contrast to conventional hemodialysis, infection related complication represents the major morbidity in this mode of renal replacement therapy. Vascular access related infection is an important cause of infection in this population. Use of central vein catheters and buttonhole cannulation in HHD are important modifiable risk factors for HHD associated infection...
October 25, 2016: Hemodialysis International
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