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Vascular access for Hd

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https://www.readbyqxmd.com/read/29444477/the-microbiome-in-chronic-kidney-disease-patients-undergoing-hemodialysis-and-peritoneal-dialysis
#1
REVIEW
Liliana Simões-Silva, Ricardo Araujo, Manuel Pestana, Isabel Soares-Silva, Benedita Sampaio-Maia
Chronic kidney disease (CKD) is associated with an imbalanced human microbiome due not only to CKD-associated factors such as uremia, increased inflammation and immunosuppression, but also to pharmacological therapies and dietary restrictions. End-stage renal disease patients require renal replacement therapies commonly in the form of hemodialysis (HD) or peritoneal dialysis (PD). HD implies the existence of a vascular access, such as an arteriovenous fistula/graft or a venous catheter, whereas PD implies a long-term peritoneal catheter and the constant inflow of peritoneal dialysate...
February 11, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29401294/the-first-365-days-on-haemodialysis-variation-in-the-haemodialysis-access-journey-and-its-associated-burden
#2
Eleanor Murray, Mahmoud Eid, Jamie P Traynor, Karen S Stevenson, Ram Kasthuri, David B Kingsmore, Peter C Thomson
Background: The modality by which haemodialysis (HD) is delivered [arteriovenous fistula (AVF), arteriovenous graft (AVG) or central venous catheter (CVC)] varies widely and is influenced by clinical evidence, patient factors and the prevailing service configuration. The aim of this study was to determine the outcome and impact of access strategy on patient outcome by mapping out the HD journey in a cohort of incident patients. Methods: A 2-year cohort of consecutive incident HD patients from the point of referral for first dialysis access to completion of the first 365 days of HD was prospectively reviewed...
February 1, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29391102/the-burden-of-tunneled-central-venous-catheters-for-hemodialysis-in-a-county-hospital
#3
Eric Pillado, Abraham Korn, Christian de Virgilio, Nina Bowens
Prolonged use of central venous catheters (CVCs) for hemodialysis (HD) is associated with greater morbidity and mortality when compared with autogenous arteriovenous fistulas (AVF). The objective was to assess compliance with CVC guidelines in adults referred for hemoaccess at a county teaching hospital. Out of 256 patients, 172 (67.2%) were male, with a mean age of 50.0 ± 12.4 years. Overall 62.5 per cent initiated dialysis via CVC. Patients were divided into two groups (those with CVC (62.5%) and those without (37...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29348924/mortality-and-hospitalizations-in-intensive-dialysis-a-systematic-review-and-meta-analysis
#4
Anna Mathew, Jody-Ann McLeggon, Nirav Mehta, Samuel Leung, Valerie Barta, Thomas McGinn, Gihad Nesrallah
Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29319771/peritoneal-dialysis-as-the-first-dialysis-treatment-option-initially-unplanned
#5
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
#6
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/29210176/online-measurement-of-hemodialysis-adequacy-using-effective-ionic-dialysance-of-sodium-a-review-of-its-principles-applications-benefits-and-risks
#7
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/29192721/haemodialysis-vascular-access-current-practices-amongst-indian-nephrologists
#8
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29188313/arteriovenous-fistula-maturation-failure-in-a-large-cohort-of-hemodialysis-patients-in-the-netherlands
#9
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/29186549/intradialytic-hypertension-is-associated-with-low-intradialytic-arterial-oxygen-saturation
#10
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
#11
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/29162677/feasibility-of-urgent-start-peritoneal-dialysis-in-older-patients-with-end-stage-renal-disease-a-single-center-experience
#12
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/29130577/factors-affecting-the-patency-of-arteriovenous-fistulas-for-hemodialysis-single-center-experience
#13
Radojica V Stolic, Goran Z Trajkovic, Mirjana M Kostic, Branko Mihailovic, Aleksandar N Jovanovic, Bratislav D Lazic, Ivana R Matijasević, Maša D Jaksić, Zlatica M Mirkovic, Tanja N Smilic, Javorka S Mitic
INTRODUCTION: Arteriovenous fistulas (AVFs) are the preferred form vascular access for hemodialysis (HD), as they have a low rate of complications and durable function. The aim of our investigation was to analyze the factors that might influence the function of AVFs. METHODS: Data were taken from the computerized patient record system in the Clinic of Urology and Nephrology, Clinical Center, Kragujevac, Serbia, for a 2-year period. We analyzed patients who had requested re-creation of AVFs as a secondary procedure...
November 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#14
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#15
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29027182/preoperative-management-of-arteriovenous-fistula-avf-for-hemodialysis
#16
Gaetano Alfano, Francesco Fontana, Mario Iannaccone, Patrizia Noussan, Gianni Cappelli
Native arteriovenous fistula (AVF) is the favorite access for hemodialysis (HD). The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recommends its creation in most patients with renal failure. Unfortunately, intensive efforts to promote native AVF in patients with marginal vessels have increased the rate of primary fistula failure. A non-functioning fistula prompts the use of central venous catheter (CVC) that, unlike AVF, has been associated with an increased risk of morbidity and mortality among patients receiving HD...
November 17, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29016441/epidemiology-and-outcomes-of-infectious-spondylodiscitis-in-hemodialysis-patients
#17
Yueh-An Lu, Wei-Chiao Sun, George Kuo, Chao-Yu Chen, Huang-Kai Kao, YuJr Lin, Chia-Hui Lee, Cheng-Chieh Hung, Ya-Chung Tian, Yu-Shien Ko, Hsiang-Hao Hsu
STUDY DESIGN: A retrospective study of patients who were hospitalized for infectious spondylodiscitis over a 13 year period. OBJECTIVE: To elucidate the epidemiology and prognostic factors of infectious spondylodiscitis in hemodialysis (HD) patients and to identify the impact of HD on infectious spondylodiscitis. SUMMARY OF BACKGROUND DATA: Only a few case studies of infectious spondylodiscitis in HD patients can be found in the literature...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28982361/distribution-of-plga-modified-nanoparticles-in-3d-cell-culture-models-of-hypo-vascularized-tumor-tissue
#18
Lee B Sims, Maya K Huss, Hermann B Frieboes, Jill M Steinbach-Rankins
BACKGROUND: Advanced stage cancer treatments are often invasive and painful-typically comprised of surgery, chemotherapy, and/or radiation treatment. Low transport efficiency during systemic chemotherapy may require high chemotherapeutic doses to effectively target cancerous tissue, resulting in systemic toxicity. Nanotherapeutic platforms have been proposed as an alternative to more safely and effectively deliver therapeutic agents directly to tumor sites. However, cellular internalization and tumor penetration are often diametrically opposed, with limited access to tumor regions distal from vasculature, due to irregular tissue morphologies...
October 5, 2017: Journal of Nanobiotechnology
https://www.readbyqxmd.com/read/28947453/association-of-vascular-access-flow-with-short-term-and-long-term-mortality-in-chronic-haemodialysis-patients-a-retrospective-cohort-study
#19
Chung-Kuan Wu, Chia-Lin Wu, Chia-Hsun Lin, Jyh-Gang Leu, Chew-Teng Kor, Der-Cherng Tarng
OBJECTIVES: To investigate the impact of vascular access flow (Qa) on vascular and all-cause mortality in chronic haemodialysis (HD) patients. DESIGN: Observational cohort study. SETTING: Single centre. PARTICIPANTS: Adult chronic HD patients at the HD unit of Shin Kong Wu Ho-Su Memorial Hospital between 1 January 2003 and 31 December 2003 were recruited. Patients were excluded if they had arteriovenous fistula or arteriovenous graft failure within 3 months before the date of Qa measurement, were aged <18 years and had Qa levels of ≥2000mL/min...
September 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28937059/the-effect-of-an-educational-program-for-vascular-access-care-on-nurses-knowledge-at-dialysis-centers-in-khartoum-state-sudan
#20
Kalthoum Ibrahim Yousif, Hasan Abu-Aisha, Omar Ibrahim Abboud
End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
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