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Vascular access for Hd

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https://www.readbyqxmd.com/read/28218363/sex-race-and-hemodialysis-vascular-access-processes
#1
Rita L McGill, Eduardo Lacson
PURPOSE: Hemodialysis (HD) patients who are female or black receive fewer arteriovenous fistulas (AVF) and more grafts (AVG). We evaluated race- and sex-based differences for three process exposures: access surgery, peripherally-inserted central catheters (PICCs), and vascular imaging. METHODS: US Renal Data System with linked Medicare claims for patients initiating HD between April 2010 - December 2011 were used to identify PICC placement, imaging, AVF and AVG surgeries, and the vascular accesses in use at individual HD treatments...
February 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28213931/successful-resumption-of-peritoneal-dialysis-following-living-donor-liver-transplantation-in-children-with-end-stage-renal-disease
#2
Hiroyuki Kanazawa, Akinari Fukuda, Mai Sato, Shingo Ishimori, Kengo Sasaki, Hajime Uchida, Takanobu Shigeta, Vidyadhar Padmakar Mali, Seisuke Sakamoto, Kenji Ishikura, Mureo Kasahara
Children with ESRD in need of RRT are commonly managed by PD due to difficulty with vascular access for HD and the relatively large extracorporeal blood volume required. Major abdominal surgery may result in injury to the peritoneum and consequent adhesion, thereby resulting in a reduction in the anatomical capacity and transport capability across the peritoneal membrane. Here, we report successful resumption of PD after LDLT in two pediatric patients. The causes of ESRD were PH1 and juvenile nephronophthisis, respectively...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28135701/catheter-failure-and-mortality-in-hemodialysis-patients-with-tunneled-cuffed-venous-catheters-in-a-single-center
#3
Min Shi, Tianlei Cui, Liang Ma, Li Zhou, Ping Fu
BACKGROUND: As of now, only a few studies have focused on the failure of tunneled cuffed venous catheter (tCVC) and mortality of hemodialysis (HD) patients using tCVC as long-term vascular access, whose vascular condition for arteriovenous fistula was not very satisfactory. In this study, we aimed to provide information about the first tCVC failure and survival rates of patients in this population. METHODS: Fifty-nine patients who used tCVC from January 1, 2009 to December 31, 2014 in our HD center were analyzed in this retrospective study and followed up either until their death or until December 31, 2015...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28133903/hypoproteinemia-as-a-prognostic-risk-factor-for-arteriovenous-fistula-failure
#4
Vedran Premuzic, Tvrtko Hudolin, Josip Pasini, Zoran Zimak, Dinko Hauptman, Bojan Jelakovic, Zeljko Kastelan
INTRODUCTION: Any vascular access is of limited duration with many factors which influence survival in patients on chronic hemodialysis (HD). Hypoproteinemia as a marker of chronic illness is common among chronic HD patients. Our aim was to analyze the survival of the primary arteriovenous fistula (AVFs) and the risk factors which influence their patency and to test the hypothesis that patients with normal values of serum proteins have lower risk of AVF failure compared to patients with hypoproteinemia...
January 29, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#5
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28067935/hepatitis-b-vaccination-in-haemodialysis-patients-an-underestimated-problem-factors-influencing-immune-responses-in-ten-years-of-observation-in-an-italian-haemodialysis-centre-and-literature-review
#6
E Cordova, I Miglia, F Festuccia, M G Sarlo, G Scornavacca, G Punzo, P Menè, C Fofi
OBJECTIVES: Despite universal infection control precautions, the risk of hepatitis B virus (HBV) infection in patients on chronic haemodialysis (HD) remains high. For this reason anti-HBV vaccination is recommended in these subjects. In hemodialyzed patients vaccinal response is often suboptimal and it's not clear what factors may influence it. STUDY DESIGN: The aim of our study is to assess the influence of some clinical and laboratory factors on seroconversion rate after anti HBV vaccination in a cohort of patients on maintenance HD...
January 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#7
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28001173/patient-in-chronic-hemodialysis-with-right-atrial-mass-thrombus-fungal-endocarditis-or-atrial-myxoma
#8
Talita G Salani, Cynthia de Moura Borges, Carolina S Urbini, Patrícia Schincariol, Kélcia Rosana da Silva Quadros, Maria Almerinda Ribeiro-Alves, Rodrigo Bueno de Oliveira
We present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD) by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA). The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI) indicated for the diagnosis of myxoma in RA...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27991478/hemodialysis-delivery-dialysis-dose-achievement-and-vascular-access-types-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcomes-and-practice-patterns-study-phase-5-2012-2015
#9
Anas AlYousef, Sumaya AlGhareeb, Jamal Al Wakeel, Saeed M G Al-Ghamdi, Brian A Bieber, Mohamad Hassan, Yacoub Al Maimani, Naser Alkandari, Haroun Z Ahmed, Ashraf Fawzy, Ronald L Pisoni
The prospective observational Dialysis Outcomes and Practice Patterns Study (DOPPS) was initiated in late 2012 in national samples of hemodialysis (HD) units (n = 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For many years, guidelines have recommended single pool Kt/V ≥1.2 as the minimum adequate dose for chronic HD patients. Here, we report initial DOPPS results regarding HD practices related to dialysis dose achievement in the GCC...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27984318/systemic-inflammatory-response-syndrome-is-not-an-indicator-of-bateremia-in-hemodialysis-patients-with-native-accesses-a-multicenter-study
#10
Daisuke Uchida, Sho Sasaki, Hiroo Kawarazaki, Masahito Miyamoto, Atsushi Nomura, Kenichiro Koitabashi, Hiroki Nishiwaki, Yugo Shibagaki
Bloodstream infection (BSI) in hemodialysis (HD) patients is often difficult to diagnose. Systemic inflammatory response syndrome (SIRS) is a sensitive predictor of BSI in the general population. We aimed to assess the usefulness of SIRS in predicting BSI in HD patients.We designed a multi-center retrospective observational study of adult (age > 18 years) HD patients who underwent 2 sets of blood cultures for suspected BSI at first hospital visit from August 2011 to July 2012. Clinical, biological, and microbial data were evaluated to evaluate SIRS as a predictor of BSI upon initial presentation to the hospital...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27964855/a-case-of-brachiocephalic-fistula-steal-and-the-emergency-physician-s-approach-to-hemodialysis-arteriovenous-fistula-complications
#11
Erica Simon, Brit Long, Kyle Johnston, Shane Summers
BACKGROUND: Chronic kidney disease is common in the United States, with many patients maintained on hemodialysis (HD). The process of HD requires vascular access through an arteriovenous (AV) fistula, AV graft, or central venous catheter. Today, as a result of the National Kidney Foundation's "Fistula First" initiative, nearly 55% of HD patients utilize an AV fistula. As there is significant morbidity and mortality associated with fistula placement and recurrent fistula cannulation, emergency physicians must be equipped to recognize and treat fistula complications...
December 10, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27957414/current-characteristics-of-dialysis-therapy-in-korea-2015-registry-data-focusing-on-elderly-patients
#12
REVIEW
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park
Because of increases in the elderly population and diabetic patients, the proportion of elderly among dialysis patients has rapidly increased during the last decades. The mortality and morbidity of these elderly dialysis patients are obviously much higher than those of young patients, but large analytic studies about elderly dialysis patients' characteristics have rarely been published. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an Internet online registry program and analyzed the characteristics...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27951575/clearance-gap-does-it-really-matter-for-the-evaluation-of-vascular-access-function
#13
Jun-Ichi Ono, Yujiro Shiraga, Fumika Yoshikawa, Yoshisuke Haruna, Tamaki Sasaki, Seiichi Mochizuki
BACKGROUNDS: Vascular access (VA) stenosis increases the risk of VA obstruction due to the gradual progress of intimal thickening. Therefore, we should try to detect VA stenosis early. However, we do not have a cutoff for when a difference between prescribed Kt/V and delivered Kt/V reflects a clinical issue. Thus, we have devised a new index, the 'clearance gap' (CL-Gap), which quantifies the difference between the effective clearance (eCL) of a hemodialysis (HD) patient and the theoretical clearance (tCL) of a dialyzer to detect a decrease in dialysis efficiency due to VA dysfunction...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#14
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/27903478/the-clinical-efficacy-of-balloon-assisted-maturation-of-autogenous-arteriovenous-fistulae
#15
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/27884849/access-hd-pilot-a-randomised-feasibility-trial-comparing-catheters-with-fistulas-in-elderly-patients-starting-haemodialysis
#16
Robert Quinn, Pietro Ravani
INTRODUCTION: The selection of the type of vascular access for haemodialysis is an important intervention question. However, only observational studies are available to inform decision-making in this area, and they are at high risk of selection bias. While a clinical trial comparing the effects of the 2 most frequently chosen strategies for haemodialysis access (fistulas and catheters) on patient important and 'hard' clinical end points is needed, the feasibility of such a trial is uncertain...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27868336/vascular-imaging-for-hemodialysis-vascular-access-planning
#17
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/27824950/urgent-start-peritoneal-dialysis-and-hemodialysis-in-esrd-patients-complications-and-outcomes
#18
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/27791255/hemodialysis-vascular-access-and-clinical-outcomes-an-observational-multicenter-study
#19
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/27772644/intensive-hemodialysis-and-potential-risks-with-increasing%C3%A2-treatment
#20
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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