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https://www.readbyqxmd.com/read/29655573/-the-reality-on-peritoneal-dialysis-in-france-40years-after
#1
Jacques Rottembourg, Guy Rostoker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased in France over the last ten years. Despite various facilities offered by the health authorities, PD remains confidential in many private units and some public hospitals. The enthusiasm present at the beginning of this technology, forty years ago, is declining, despite a real improvement in new developments, a real increase in patient survival, today at least similar to that on hemodialysis. Then, the aim of this review is first to give a summary of the principles and practice of patient and staff education and to describe the role of the medical contribution in decision-making...
April 11, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29624859/comparison-between-open-and-pharmacomechanical-repair-of-acutely-thrombosed-arteriovenous-hemodialysis-fistulae-within-a-decade
#2
Susanne Regus, Veronika Almási-Sperling, Ulrich Rother, Alexander Meyer, Axel Schmid, Michael Uder, Werner Lang
INTRODUCTION: Different declotting techniques are available for acutely thrombosed arteriovenous hemodialysis fistulae (AVF). The aim of this single-center study was to compare immediate and follow-up results between surgical repair and a modified interventional lyse-and-wait technique characterized by prolonged local reaction times of recombinant tissue-plasminogen activator (rtPA). MATERIALS AND METHODS: We retrospectively analyzed medical records of 110 consecutively treated patients between the years 2003 and 2013...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29619320/-corynebacterium-jeikeium-endocarditis-a-case-report-and-comprehensive-review-of-an-underestimated-infection
#3
Kaveh Rezaei Bookani, Rachel Marcus, Eyad Cheikh, Monireh Parish, Usman Salahuddin
Diphtheroids are gram-positive pleomorphic bacilli in the family of Coryneform bacteria. These organisms are present as part of the human flora. Past practice habits had been to consider them as contaminants when isolated from clinical samples. Corynebacterium jeikeium is one of the most clinically important nondiphtherial Corynebacteria that can cause different forms of infections specifically in patients with underlying risk factors and co-morbidities including immunocompromised subjects. Through this article, we present a 67-year-old gentleman with extensive co-morbidities including heart failure with reduced ejection fraction and ESRD on hemodialysis through a femoral catheter who presented with chest pain and fatigue...
2018: IDCases
https://www.readbyqxmd.com/read/29618823/oxygen-extraction-ratio-oer-as-a-measurement-of-hemodialysis-hd-induced-tissue-hypoxia-a-pilot-study
#4
Silverio Rotondi, Lida Tartaglione, Maria Luisa Muci, Alessio Farcomeni, Marzia Pasquali, Sandro Mazzaferro
HD tissue hypoxia associates with organ dysfunctions. OER, the ratio between SaO2 and central-venous-oxygen-saturation, could estimate oxygen requirements during sessions, but no data are available. We evaluated OER behavior in 20 HD patients with permanent central venous catheter (CVC) as vascular access. Pre-HD OER (33.6 ± 1.4%; M ± SE) was higher than normal (range 20-30%). HD sessions increased OER to 39.2 ± 1.5% (M ± SE; p < 0.05) by 30' and to 47.4 ± 1.5% (M ± SE; p < 0...
April 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29615350/a-technique-for-the-salvage-of-megafistulas-allowing-immediate-dialysis-access
#5
Nosratollah Nezakatgoo, Steven D Kozusko, Jefferson T Watson, Rebecca Empting, Charles P Shahan, Michael J Rohrer
OBJECTIVE: Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation of the AVF, resulting in the development of a megafistula, is a complication that can result in a need for AVF revision and subsequent failure. METHODS: The charts of patients who underwent autogenous AVF revision because of the development of a megafistula with aneurysmectomy and vein transposition by a single surgeon during a 7-year period from 2009 through 2016 were reviewed...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29615168/reasons-for-removal-of-non-tunneled-double-lumen-catheters-in-incident-dialysis-patients
#6
Ruqaya Qureshi, Beena Salman, Salman Imtiaz, Murtaza F Drohlia, Aasim Ahmad
OBJECTIVE: To evaluate the reasons of removal of non-tunneled double lumen catheters (NTDLC) in incident hemodialysis (HD) patients in a tertiary renal care hospital. STUDY DESIGN: Observational retrospective study. PLACE AND DURATION OF STUDY: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKC PGTI), Karachi, from June 2015 to May 2016. METHODOLOGY: All patients were selected who had naive NTDLC placement at TKC PGTI either in Emergency Room (ER) or Intensive Care Unit (ICU) during the study period...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29611117/intestinal-perforation-by-a-peritoneal-dialysis-catheter-in-which-fungal-peritonitis-led-to-diagnosis-a-rare-case-report
#7
Hisato Shima, Shogo Mizoguchi, Yuji Morine, Manabu Tashiro, Kazuyoshi Okada, Jun Minakuchi, Shu Kawashima
Intestinal perforation by a peritoneal catheter is an uncommon, but serious, complication that has a high mortality rate. Intestinal perforation in peritoneal dialysis (PD) patients is difficult to diagnose using symptoms and radiological findings, which may result in a delay in diagnosis. Moreover, intestinal perforation complicated with fungal peritonitis is reportedly a severe condition with a poor prognosis. Herein, we report the case of a 78-year-old man on PD, whose diagnosis of perforative peritonitis was difficult to diagnose preoperatively...
April 2, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29609536/effects-of-dialysate-to-serum-sodium-na-alignment-in-chronic-hemodialysis-hd-patients-retrospective-cohort-study-from-a-quality-improvement-project
#8
Jochen G Raimann, Linda H Ficociello, Len A Usvyat, Hanjie Zhang, Lisa Pacelli, Sandi Moore, Penny Sheppard, Qingqing Xiao, Yuedong Wang, Claudy Mullon, Paul Balter, Terry Sullivan, Peter Kotanko
BACKGROUND: Evidence indicates favorable effects of dialysate (DNa+ ) to serum sodium concentration (SNa+ ) alignment, however, results from larger sample populations are needed. For this reason, we conducted a retrospective propensity score-matched cohort study from a quality improvement project to investigate the effects of alignment on population of maintenance hemodialysis patients. METHODS: At 4 participating hemodialysis (HD) clinics, patients with SNa+ lower than the standard DNa+ of 137 mEq/L who received HD with DNa+ aligned to the average of the last 4 SNa+ measurements were evaluated (clinicaltrials...
April 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29602630/medicare-costs-associated-with-arteriovenous-fistulas-among-us-hemodialysis-patients
#9
Mae Thamer, Timmy C Lee, Haimanot Wasse, Marc H Glickman, Joyce Qian, Daniel Gottlieb, Scott Toner, Timothy A Pflederer
BACKGROUND: An arteriovenous fistula (AVF) is the recommended vascular access for hemodialysis (HD). Previous studies have not examined the resources and costs associated with creating and maintaining AVFs. STUDY DESIGN: Retrospective observational study. SETTING & PARTICIPANTS: Elderly US Medicare patients initiating hemodialysis therapy during 2010 to 2011. PREDICTOR: AVF primary and secondary patency and nonuse in the first year following AVF creation...
March 28, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29597214/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvement
#10
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29594145/exit-site-infection-due-to-mycobacterium-chelonae-in-an-elderly-patient-on-peritoneal-dialysis
#11
Arata Hibi, Takahisa Kasugai, Keisuke Kamiya, Chiharu Ito, Satoru Kominato, Toshiyuki Miura, Katsushi Koyama
Nontuberculous mycobacteria (NTM) are rarely isolated from peritoneal dialysis (PD)-associated catheter infections. However, NTM infection is usually difficult to treat and leads to catheter loss. Prompt diagnosis is essential for appropriate treatment. A 70-year-old Japanese man who had been on PD for 2 years and with a medical history of 2 episodes of exit site infections (ESIs) due to methicillin-resistant Staphylococcus aureus was admitted to the hospital due to suspected ESI recurrence. However, Gram staining of the pus revealed no gram-positive cocci...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29592765/alternative-surgical-procedure-for-treating-superior-vena-cava-syndrome-in-a-hemodialysis-patient
#12
Chen L Yao, Zheng L Tan, Ran Tian, Peng Miao, Xin Chen, Zheng Y Yu
BACKGROUND: The incidence of superior vena cava syndrome has been increasing in hemodialysis patients with the widespread use of dialysis catheters. Although endovascular intervention remains the primary choice for treatment, the long-term patency rate is not optimistic. Occlusive lesions are often encountered that cannot be opened using this intervention. Therefore, we chose to present this case involving a pericardial patch used to reconstruct the superior vena cava in the treatment of catheter-associated chronic superior vena cava occlusion...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29587560/location-and-structure-of-fibrous-sheath-formed-after-placing-a-tunneled-hemodialysis-catheter-in-a-large-pig-model
#13
Marius C Florescu, Joseph Runge, Maurino Flora, George Nio, John Lof, Elizabeth Stolze, Gretchen Fry, Stanley J Radio, Kirk W Foster
BACKGROUND AND OBJECTIVES: We evaluated the location and structure of the fibrous sheath formed after the placement of tunneled, cuffed hemodialysis catheters in large animals, 70 kg pigs. We focused on describing the location of the fibrous sheath in relation to the catheter. Its location explains the fibrous sheath's ability to cause catheter dysfunction by covering the catheter exit ports located at the catheter's tip. DESIGN: We used three animals. Each animal had a tunneled, cuffed, 15-French diameter hemodialysis catheter placed in the external jugular vein, with the tip at the junction of the superior vena cava and the right atrium...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29587251/pregnancy-outcomes-in-french-hemodialysis-patients
#14
Gabrielle Normand, Xiaoli Xu, Marine Panaye, Anne Jolivot, Sandrine Lemoine, Fitsum Guebre-Egziabher, Evelyne Decullier, Sylvie Bin, Muriel Doret, Laurent Juillard
BACKGROUND: Pregnancy in hemodialysis (HD) women is a rare event and often associated with maternal and fetal complications. Scarcity of available data from large cohorts impedes fair medical counseling. METHODS: This is a descriptive, retrospective, multi-centric study. Pregnant women on HD during the period from 1985 to 2015 in France were included. The primary outcome was a living infant discharged from hospital, while secondary outcomes included gestational age and birth weight...
March 27, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29582680/catheter-related-complications-and-survival-among-incident-hemodialysis-patients-in-singapore
#15
Hao-Yun Yap, Suh-Chien Pang, Chieh-Suai Tan, Yi-Liang Tan, Nicholette Goh, Shaam Achudan, Kian-Guan Lee, Ru-Yu Tan, Lina Hui-Lin Choong, Tze-Tec Chong
INTRODUCTION: Hemodialysis is the main modality of renal replacement therapy in Singapore. However, a majority of the patients in Singapore are initiated on hemodialysis via a catheter. This study examines the complication rates and factors predicting catheter-related bloodstream infections and mortality rates in patients who were initiated on hemodialysis at our institution. METHODS: This is a single-center retrospective analysis of incident hemodialysis patients who were initiated on renal replacement therapy between 1 January 2010 and 31 December 2012...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29582678/vascular-access-via-translumbar-hemodialysis-reliable-outflow-dialysis-catheter-in-a-case-of-severe-central-venous-occlusion
#16
Anatoly Loskutov, Atman Dave, Christie Gooden, Nathan A Saucier, Kenneth H Cho, Brandt C Wible, John J Borsa
No abstract text is available yet for this article.
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29575978/decreasing-dialysis-catheter-rates-by-creating-a-multidisciplinary-dialysis-access-program
#17
Patricia M Rosenberry, Silke V Niederhaus, Eugene J Schweitzer, David B Leeser
INTRODUCTION: Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29562822/vascular-mapping-for-the-decision-of-hemodialysis-access-method-case-report
#18
Takashi Uchino, Hiromasa Nakai, Hiroaki Ichihashi, Tsukasa Sasaki, Nakanobu Azuma
Preoperative ultrasound vascular mapping was performed to determine the surgical method for two cases where standard arteriovenous fistula was not possible. In case 1, the previous arteriovenous fistula of the left arm was occluded, and arteriovenous graft of the right arm was thrombosed after frequent percutaneous transluminal angioplasty. Contrast medium was contraindicated because of allergy. Using preoperative ultrasound vascular mapping, we were able to establish the appropriate surgical method. In case 2, hemodialysis was started by catheter insertion, and then access creation was planned...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29561271/convectively-dominated-heparin-leakage-from-multiple-catheter-designs-an-in-vitro-experimental-study
#19
Michael Coleman Barbour, Kenneth W Gow, Alberto Aliseda
Central venous catheters (CVCs) are routinely filled with a heparin lock while not in use to avoid thrombus formation near the tip. However, heparin leakage is known to occur, and the lock effectiveness remains in question. It was recently shown that convective fluxes from the blood flow in the host vein transport the majority of locking solution away from the tip of hemodialysis catheters immediately after instillation. Combined with the low diffusivity of heparin, this results in concentrations of heparin at the catheter tip that are orders of magnitude lower than at instillation for the majority of the interdialytic phase, diminishing the antithrombotic effectiveness of the lock...
March 16, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29560785/endovascular-bypass-for-salvage-of-vascular-access-in-hemodialysis-catheter-consigned-patients
#20
Matt Chiung-Yu Chen, Mei-Jui Weng, Huei-Lung Liang
PURPOSE: This study was performed to retrospectively assess the efficacy of percutaneous creation of an intervascular bypass with or without stent graft deployment (endovascular bypass) for salvage of abandoned vascular access sites in hemodialysis catheter-consigned patients. METHODS: Salvage of abandoned vascular access sites was attempted in 16 patients with hemodialysis catheters. These vascular access sites were salvaged using endovascular bypass techniques to redirect the access flow to a nonarterialized vein as a new outflow conduit or cannulation segment...
March 1, 2018: Journal of Vascular Access
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