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dialysis access

Anubhav Bussooa, Steven Neale, John R Mercer
Cardiovascular disease remains the leading cause of death in Western society. Recent technological advances have opened the opportunity of developing new and innovative smart stent devices that have advanced electrical properties that can improve diagnosis and even treatment of previously intractable conditions, such as central line access failure, atherosclerosis and reporting on vascular grafts for renal dialysis. Here we review the latest advances in the field of cardiovascular medical implants, providing a broad overview of the application of their use in the context of cardiovascular disease rather than an in-depth analysis of the current state of the art...
June 22, 2018: Sensors
Dhaval Kolte, Sahil Khera, Sreekanth Vemulapalli, Dadi Dai, Stephan Heo, Andrew M Goldsweig, Herbert D Aronow, Sammy Elmariah, Ignacio Inglessis, Igor F Palacios, Vinod H Thourani, Barry L Sharaf, Paul C Gordon, J Dawn Abbott
OBJECTIVES: The authors sought to examine outcomes and identify independent predictors of mortality among patients undergoing urgent/emergent transcatheter aortic valve replacement (TAVR). BACKGROUND: Data on urgent/emergent TAVR as a rescue therapy for decompensated severe aortic stenosis (AS) are limited. METHODS: The Society of Thoracic Surgeons and the American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry linked with Centers for Medicare & Medicaid Services claims was used to identify patients who underwent urgent/emergent versus elective TAVR between November 2011 and June 2016...
June 25, 2018: JACC. Cardiovascular Interventions
William L Salzer
Peritoneal dialysis is an effective treatment modality for patients with end-stage renal disease. The relative use of peritoneal dialysis versus hemodialysis varies widely by country. Data from a 2004 survey reports the percentage of patients with end-stage renal disease treated with peritoneal dialysis to be 5%-10% in economically developed regions like the US and Western Europe to as much as 75% in Mexico. This disparity is probably related to the availability and access to hemodialysis, or in some cases patient preference for peritoneal over hemodialysis...
2018: International Journal of Nephrology and Renovascular Disease
Ivo Laranjinha, Patrícia Matias, Ana Azevedo, David Navarro, Carina Ferreira, Tiago Amaral, Marco Mendes, Inês Aires, Cristina Jorge, Célia Gil, Anibal Ferreira
INTRODUCTION: An arteriovenous (AV) access flow (Qa) of 400 mL/min is usually sufficient for an effective hemodialysis (HD), but some accesses continue developing and become high flow accesses (HFA). Some authors postulated that an HFA might shift a significant portion of dialyzed blood from the cardiac output, which could decrease HD efficiency and lead to volume overload. OBJECTIVE: The aim of our study was to evaluate if HFA is associated with reduced HD efficiency and/or volume overload in prevalent HD patients...
May 28, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Priscila Ruppel, Claudia R Felipe, Jose O Medina-Pestana, Liliane Lumi Hiramoto, Laila Viana, Alexandra Ferreira, Wilson Aguiar, Mayara Ivani, Adrieli Bessa, Marina Cristelli, Melissa Gaspar, Helio Tedesco-Silva
INTRODUCTION: The risk of death after kidney transplant is associated with the age of the recipient, presence of comorbidities, socioeconomic status, local environmental characteristics and access to health care. OBJECTIVE: To investigate the causes and risk factors associated with death during the first 5 years after kidney transplantation. METHODS: This was a single-center, retrospective, matched case-control study. RESULTS: Using a consecutive cohort of 1,873 kidney transplant recipients from January 1st 2007 to December 31st 2009, there were 162 deaths (case group), corresponding to 5-year patient survival of 91...
June 4, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Kevin F Erickson, Samaya Qureshi, Wolfgang C Winkelmayer
Rapid growth in electronic communications and digitalization, combined with advances in data management, analysis, and storage, have led to an era of "Big Data." The Social Security Amendments of 1972 turned end-stage renal disease (ESRD) care into a single-payer system for most patients requiring dialysis in the United States. As a result, there are few areas of medicine that have been as influenced by Big Data as dialysis care, for which Medicare's large administrative data sets have had a central role in the evaluation and development of public policy for several decades...
June 16, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Yukiko Hasuike, Naoto Kakita, Makoto Aichi, Satoko Masachika, Mari Kantou, Shoko Ikeda Takahashi, Masayoshi Nanami, Yasuyuki Nagasawa, Takahiro Kuragano, Takeshi Nakanishi
OBJECTIVE: For patients with end-stage renal disease on hemodialysis, the durability of vascular access (VA) is still far from optimal, and access survival after intervention for access failure is an important aspect. Procoagulant status is a leading cause of access failure. Coagulation-fibrinolysis imbalance can occur in hemodialyzed patients, but the influence of the imbalance has not been fully elucidated. METHODS: We prospectively examined coagulation-fibrinolysis balance to assess the risk of access failure after the intervention of revascularization in a cohort of 462 hemodialysis patients...
June 15, 2018: Journal of Vascular Surgery
Mary G Bowring, Lauren M Kucirka, Allan B Massie, Tanveen Ishaque, Sunjae Bae, Ashton A Shaffer, Jacqueline Garonzik Wang, Mark Sulkowski, Niraj Desai, Dorry L Segev, Christine M Durand
BACKGROUND: The availability of direct-acting antiviral (DAA) therapy might have impacted use of HCV-infected (HCV+) deceased-donor kidneys for transplantation. METHODS: We used 2005-2018 SRTR data to identify 18 936 candidates willing to accept HCV+ kidneys and 3348 HCV+ recipients of HCV+ kidneys. We compared willingness to accept, utilization, discard, and posttransplant outcomes associated with HCV+ kidneys between 2 treatment eras (Interferon [IFN] era: 1/1/2005-12/5/2013 versus DAA era: 12/6/2013-8/2/2018)...
June 13, 2018: Transplantation
Freya Van Hulle, Florence Bonkain, Dieter De Clerck, Dimitri Aerden, Isabelle Vanwijn, Christian Tielemans, Karl Martin Wissing
BACKGROUND: There are few data to inform decisions about the optimal management of occluded tunneled cuffed hemodialysis catheters with thrombolytic locking solutions. The effect of dose, dwell-time, and number of administrations remains controversial. METHODS: In this retrospective single-center review of tunneled cuffed catheters used between 2010 and 2014, restoration of blood flow as well as pre- and post-pump pressures after either short (30 min) or prolonged (48-72 h) administration of 100,000 IU of urokinase locking solution was evaluated in all thrombotic dysfunctions...
June 1, 2018: Journal of Vascular Access
Charles D Fraser, Joshua C Grimm, Rui Han Liu, Russell N Wesson, Faris Azar, Robert J Beaulieu, Thomas Reifsnyder
INTRODUCTION: Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This study evaluates the indications for, and safety of, arteriovenous fistula (AVF) removal in patients following successful renal transplantation. METHODS: All patients that underwent AVF excision at a single institution from 2006-2016 were retrospectively reviewed...
June 7, 2018: Annals of Vascular Surgery
Timmy Lee, Silvi Shah, Anthony C Leonard, Pratik Parikh, Charuhas V Thakar
BACKGROUND: Acute kidney injury (AKI) is associated with increased morbidity and mortality. Mortality in end-stage renal disease (ESRD) patients is highest during the first year of dialysis. The impact of pre-ESRD AKI events on long-term outcomes in incident ESRD patients remains unknown. METHODS: We evaluated a retrospective cohort of 47,341 incident hemodialysis patients from the United States Renal Data System with linked Medicare data for at least 2 years prior to hemodialysis initiation...
June 7, 2018: American Journal of Nephrology
Hugo Ferreira, Ana T Nunes, Ana Oliveira, Ana Beco, Joana Santos, Manuel Pestana
BACKGROUND: Peritoneal dialysis (PD) is an effective renal replacement technique. However, every year a considerable number of patients are transferred to hemodialysis (HD). Our aim was to identify those at risk, in order to place an arteriovenous fistula (AVF). METHODS: Case-control study enrolling all prevalent patients in 2014 and 2015 in our clinic. Groups: 72 case patients who were transferred definitively to HD, 111 control patients (remaining on PD, transplanted, recovered renal function, or deceased)...
June 6, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Leonardo Spatola, Silvia Finazzi, Albania Calvetta, Claudio Angelini, Salvatore Badalamenti
INTRODUCTION: Malnutrition is a well-recognized risk factor for all-cause mortality in hemodialysis patients. However, its role for arteriovenous fistulas outcome has not been exhaustively investigated. Our aim was to point out the impact of Subjective Global Assessment-Dialysis Malnutrition Score as independent predictor of arteriovenous fistulas thrombosis (vascular access thrombosis) and/or significant stenosis (vascular access stenosis). In addition, we compared it with the widespread Charlson Comorbidity Index...
June 1, 2018: Journal of Vascular Access
Rosario Spina, Baudolino Mussa, Lara Tollapi, Fabio Conti, Enrico Cortesi, Roberto Verna
Vascular access is the commonest invasive procedure in secondary care. Vascular access is understood as being access to the bloodstream of acute and chronic patients for diagnostic and therapeutic purposes such as blood sampling, vessel pressure monitoring, fluid infusions (blood transfusions, parenteral nutrition), pharmacological treatments (e.g. antibiotic therapies, chemotherapy, analgesic therapies) or apheresis/dialysis through catheters that may remain in the vessels for weeks or months. There is a wide variety of options available for venous access...
June 2018: Minerva Medica
Dev Jegatheesan, David W Johnson, Yeoungjee Cho, Elaine M Pascoe, Darsy Darssan, Htay Htay, Carmel Hawley, Philip A Clayton, Monique Borlace, Sunil V Badve, Kamal Sud, Neil Boudville, Stephen P McDonald, Annie-Claire Nadeau-Fredette
BACKGROUND: Obesity is increasingly prevalent worldwide, and a greater number of patients initiate renal replacement therapy with a high body mass index (BMI). This study aimed to evaluate the association between BMI and organism-specific peritonitis. METHODS: All adult patients who initiated peritoneal dialysis (PD) in Australia between January 2004 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry...
May 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Badri M Shrestha, Donna Shrestha, Avneesh Kumar, Alice Shrestha, Simon A Boyes, Martin E Wilkie
BACKGROUND: The optimal methodology of establishing access for peritoneal dialysis (PD) remains controversial. Previously published randomized controlled trials and cohort studies do not demonstrate an advantage for 1 technique over another. Four published meta-analyses comparing outcomes of laparoscopic versus open PD catheter (PDC) insertion have given inconsistent conclusions and are flawed since they group basic and advanced laparoscopy together. The aim of this systematic review and meta-analysis is to examine whether advanced laparoscopic interventions consisting of rectus sheath tunneling and adjunctive procedures produce a better outcome than open insertion or basic laparoscopy used only to verify the catheter position...
May 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Abdul Rehman Qureshi, Naureen Durrani, Naila Asif
OBJECTIVE: To analyse the association of vital sign variations with complications during dialysis among end-stage renal disease patients. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Dialysis Centre, Memon Medical Institute Hospital, Karachi, Pakistan, from December 2016 to February 2017. METHODOLOGY: Patients on regular hemodialysis with permanent vascular access were selected. Analysis was done during their regular hemodialysis session...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Julien Al Shakarchi, Nicholas Inston
PURPOSE: Early cannulation grafts are specifically designed for dialysis, whereas standard expanded polytetrafluoroethylene grafts were not. There is developing collective experience and literature available to allow the assessment of outcomes of these early cannulation grafts. The aim of this review was to review the evidence for both short- and long-term outcomes of early cannulation grafts. METHODS: Using standardized searches of electronic databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the primary outcomes for this study were primary and secondary patency rates for early cannulation grafts for dialysis at 12 months and beyond...
May 1, 2018: Journal of Vascular Access
William W Sheaffer, Patrick T Hangge, Anthony H Chau, Sadeer J Alzubaidi, M-Grace Knuttinen, Sailendra G Naidu, Suvranu Ganguli, Rahmi Oklu, Victor J Davila
Dialysis associated steal syndrome (DASS) is a relatively rare but debilitating complication of arteriovenous fistulas. While mild symptoms can be observed, if severe symptoms are left untreated, DASS can result in ulcerations and limb threatening ischemia. High-flow with resultant heart failure is another documented complication following dialysis access procedures. Historically, open surgical procedures have been the mainstay of therapy for both DASS as well as high-flow. These procedures included ligation, open surgical banding, distal revascularization-interval ligation, revascularization using distal inflow, and proximal invasion of arterial inflow...
May 29, 2018: Journal of Clinical Medicine
Macey L Henderson
Purpose of review: Living donor transplantation offers patients with end-stage renal disease faster access to transplant and better survival and quality of life than waiting for a deceased donor or remaining on dialysis. While many people state they would be willing to help someone in need through kidney donation, there are education and communication barriers to donor candidate identification. These barriers might be mitigated by technological innovations, including the use of social media...
March 2018: Current Transplantation Reports
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