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https://www.readbyqxmd.com/read/28983900/predicting-tissue-plasminogen-activator-use-and-success-in-in-center-hemodialysis-patients
#1
Sarah Daisy Kosa, Chenglin Ye, Lehana Thabane, Amiram Gafni, Charmaine E Lok
INTRODUCTION: Hemodialysis catheter malfunction is problematic. We aimed to determine clinical, catheter, and hemodialysis variables that predict: (i) catheter malfunction requiring recombinant tissue-plasminogen activator (TPA) treatment and (ii) the success of TPA administration. METHODS: Clinical, catheter, and hemodialysis variables were collected from a cohort of 559 catheters (141,526 catheter days) in 175 hemodialysis patients (2008-2011). Time to, and predictors of, catheter malfunction were determined for all catheters and primary catheters only, analyzed by Cox-proportional hazard model, multi-variable logistic regression model, and mixed-effect logistic regression models...
October 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28890326/taurolidine-based-catheter-lock-regimen-significantly-reduces-overall-costs-infection-and-dysfunction-rates-of-tunneled-hemodialysis-catheters
#2
Wolfgang Winnicki, Harald Herkner, Matthias Lorenz, Ammon Handisurya, Željko Kikić, Bernhard Bielesz, Benjamin Schairer, Thomas Reiter, Farsad Eskandary, Gere Sunder-Plassmann, Guerkan Sengoelge
Catheter-related infections and dysfunction are the main catheter complications causing morbidity and mortality in hemodialysis patients. However, there are no consistent data for the choice of catheter lock solutions for tunneled hemodialysis lines. In this prospective, multicenter, randomized, controlled trial, two lock regimens using three commercial catheter lock solutions were compared in 106 hemodialysis patients with a newly inserted tunneled central catheter. In the taurolidine group, TauroLock™-Hep500 was used twice per week and TauroLock™-U25,000 once a week...
September 7, 2017: Kidney International
https://www.readbyqxmd.com/read/28862725/longitudinal-dialysis-adequacy-and-clinical-performance-of-the-vectorflow-hemodialysis-catheter-a-prospective-study
#3
John R Ross, Tatiana A Puga, Thomas E Philbeck
PURPOSE: To report clinical performance and longitudinal assessment of hemodialysis adequacy with the Arrow-Clark VectorFlow catheter, a symmetrical-tip device with a distal lumen configuration designed to reduce platelet shear stress and catheter thrombosis. METHODS AND MATERIALS: We prospectively enrolled patients who required de novo placement of a chronic tunneled catheter for hemodialysis or exchange of a dysfunctional catheter as part of an Institutional Review Board (IRB)-approved protocol...
August 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28822660/prospective-randomized-study-of-long-term-hemodialysis-catheter-removal-versus-guidewire-exchange-to-treat-catheter-related-bloodstream-infection
#4
Hossam M Saleh, Mohamed M Tawfik, Hesham Abouellail
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28777417/outcomes-of-three-types-of-native-arteriovenous-fistula-in-a-single-center
#5
Emiliano Chisci, Linda M Harris, Francesco Menici, Pierfrancesco Frosini, Eugenio Romano, Nicola Troisi, Leonardo Ercolini, Stefano Michelagnoli
OBJECTIVE: To study the outcomes of three different types of native arteriovenous fistula (AVF), the distal (D: radial-cephalic), middle-arm (MA: radial-cephalic) and proximal (P: brachial-cephalic) AVF access creation for hemodialysis patients in a single center. METHODS: An 8-year retrospective review, from 2006 to 2014, was conducted at a single institution in which the surgical outcomes for three different types of native AVF creation were reviewed. Preoperative duplex vein mapping was obtained in all patients to choose the best vein and site for access...
July 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28717371/the-effects-of-probiotic-supplement-on-hemoglobin-in-chronic-renal-failure-patients-under-hemodialysis-a-randomized-clinical-trial
#6
Zahra Shariaty, Gholam Reza Mahmoodi Shan, Mehran Farajollahi, Monireh Amerian, Naser Behnam Pour
BACKGROUND: Chronic inflammation is one of the causes of anemia in chronic renal failure patients under hemodialysis. Probiotics probably establish a balance between pro- and anti-inflammatory cytokines. The study was conducted to determine the effects of probiotic supplementation on hemoglobin (Hb) in hemodialysis patients. MATERIALS AND METHODS: A parallel clinical trial was conducted in which patients were randomly allocated into two groups. The intervention group (n = 18) was given a 500 mg probiotic supplement (a capsule) every day whereas the control group (n = 18) received placebo (a capsule), both for 3 months...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28702138/prevalence-and-clinical-features-of-cryptosporidium-infection-in-hemodialysis-patients
#7
Mohammad Ali Mohaghegh, Seyed Hossein Hejazi, Mohsen Ghomashlooyan, Hamed Kalani, Farzaneh Mirzaei, Mehdi Azami
AIM: This cross-sectional study aims to assess the prevalence of Cryptosporidium in hemodialysis patients compared with healthy individuals in central Iran from August 2014 to January 2015. BACKGROUND: Cryptosporidiosis is a major cause of acute and persistent diarrhea with significant morbidity and mortality in immunocompromised patients such as those undergoing renal dialysis. METHODS: Three stool samples were collected from 330 hemodialysis patients and 150 healthy individuals on 3 consecutive days...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28389745/short-frequent-5-days-per-week-in-center-hemodialysis-versus-3-days-per-week-treatment-a-randomized-crossover-pilot-trial-through-the-midwest-pediatric-nephrology-consortium
#8
Benjamin L Laskin, Guixia Huang, Eileen King, Denis F Geary, Christoph Licht, Joshua P Metlay, Susan L Furth, Tom Kimball, Mark Mitsnefes
BACKGROUND: No controlled trials in children with end-stage kidney disease have assessed the benefits of more frequently administered hemodialysis (HD). METHODS: We conducted a multicenter, crossover pilot trial to determine if short, more frequent (5 days per week) in-center HD was feasible and associated with improvements in blood pressure compared with three conventional HD treatments per week. Because adult studies have not controlled for the weekly duration of dialysis, we fixed the total treatment time at 12 h a week of dialysis during two 3-month study periods; only frequency varied from 5 to 3 days per week between study periods...
August 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28381917/dosing-of-enoxaparin-in-renal-impairment
#9
Suhail A Shaikh, Randolph E Regal
OBJECTIVE: To review enoxaparin treatment dosing, pharmacokinetics, and clinical outcomes data in patients with renal impairment and to examine the current two-tiered dosing regimen approved by the Food and Drug Administration (FDA). DATA SOURCES: A literature search of PubMed (1990-2016) was performed using the search terms low-molecular-weight heparin, unfractionated heparin, bleeding, enoxaparin, renal impairment, pharmacokinetics, and hemodialysis. STUDY SELECTION AND DATA EXTRACTION: All studies assessing the pharmacokinetic properties of enoxaparin in patients with renal impairment were evaluated...
April 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28355402/budd-chiari-syndrome-secondary-to-catheter-associated-inferior-vena-cava-thrombosis
#10
Gustavo N Araujo, Luciane M Restelatto, Carlos A Prompt, Cristina Karohl
INTRODUCTION: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. CASE REPORT: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28352017/basilic-vein-transposition-a-viable-alternative-for-multiple-failed-arteriovenous-fistulas-a-single-center-experience
#11
Saurabh Sudhir Chipde, Santosh Agrawal, Jaisukh Kalathia, Udit Mishra, Rajeev Agrawal
Primary use of the autogenous arteriovenous access is recommended by the National Kidney Foundation-Dialysis Outcomes Quality Initiative guidelines. In spite of troublesome comorbidities associated with basilic vein transposition (BVT), it is still the most preferred technique when autologous veins are not suitable to construct radio-cephalic fistula (RCF) and brachiocephalic fistula (BCF), arteriovenous fistula (AVF). The present study highlights our experience with BVT, with small incision technique, over a period of two years with excellent outcome...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28343298/thiazide-increases-serum-calcium-in-anuric-patients-the-role-of-parathyroid-hormone
#12
Raquel F V Vasco, Eduardo T Reis, Rosa M A Moyses, Rosilene M Elias
We evaluated the effect of hydrochlorothiazide in a sample of anuric patients on hemodialysis and found an increase in serum calcium, which occurred only in those with parathyroid hormone >300 pg/ml. This finding highlights the extra-renal effect of this diuretic and a possible role of parathyroid hormone in the mechanism. PURPOSE: Thiazide diuretics are commonly used in patients with chronic kidney disease to treat hypertension. Their effects on calcium and bone metabolism are not well established, once calciuria may not fully explain levels of calcium and parathyroid hormone (PTH) in this population...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#13
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28165583/chlorhexidine-impregnated-transparent-dressings-decrease-catheter-related-infections-in-hemodialysis-patients-a-quality-improvement-project
#14
MULTICENTER STUDY
Ibironke W Apata, John Hanfelt, James L Bailey, Vandana Dua Niyyar
PURPOSE: Central venous catheters (CVC) are associated with increased infection rates, morbidity and mortality compared to other hemodialysis vascular access. Chlorhexidine-impregnated transparent (CHG-transparent) dressings allow for continuous antimicrobial exposure and easy visibility of the CVC insertion site. We conducted a quality improvement project to compare catheter-related infection (CRI) rates in two dressing regimens - CHG-transparent dressings and adhesive dry gauze dressing in hemodialysis patients with tunneled CVCs...
March 21, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28152751/identifying-avoidable-terminal-oncology-icu-hospitalizations
#15
Andrew Hantel, Blase N Polite
56 Background: Eight percent of cancer patients expire in the ICU. There is no association between spending on aggressive end of life (EOL) care and survival outcomes. This aggressive care is also associated with reduced quality of life for patients and families. The National Quality Forum endorses the number of patients admitted to the ICU in the last 30 days of life as a quality of care measure. Our hypothesis is that a significant number of oncology patients suffer avoidable terminal ICU hospitalizations...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28094031/patients-receiving-frequent-hemodialysis-have-better-health-related-quality-of-life-compared-to-patients-receiving-conventional-hemodialysis
#16
Amit X Garg, Rita S Suri, Paul Eggers, Fredric O Finkelstein, Tom Greene, Paul L Kimmel, Alan S Kliger, Brett Larive, Robert M Lindsay, Andreas Pierratos, Mark Unruh, Glenn M Chertow
Most patients with end-stage kidney disease value their health-related quality of life (HRQoL) and want to know how it will be affected by their dialysis modality. We extended the findings of two prior clinical trial reports to estimate the effects of frequent compared to conventional hemodialysis on additional measures of HRQoL. The Daily Trial randomly assigned 245 patients to receive frequent (six times per week) or conventional (three times per week) in-center hemodialysis. The Nocturnal Trial randomly assigned 87 patients to receive frequent nocturnal (six times per week) or conventional (three times per week) home hemodialysis...
March 2017: Kidney International
https://www.readbyqxmd.com/read/28078825/ethanol-combined-with-heparin-as-a-locking-solution-for-the-prevention-of-catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-randomized-study
#17
Sofia Sofroniadou, Ioanna Revela, Alexandros Kouloubinis, Ioanna Makriniotou, Sinodi Zerbala, Despina Smirloglou, Petros Kalocheretis, Apostolos Drouzas, George Samonis, Christos Iatrou
INTRODUCTION: Ethanol lock solution has been mainly administered in paediatric and home parenteral nutrition patients in order to prevent catheter related blood stream infections (CRBSI). Its utility in hemodialysis (HD) patients with non-tunneled-uncuffed catheter (NTC) has been poorly explored. METHODS: We conducted a prospective randomized study in chronic HD patients requiring a newly inserted NTC-while awaiting for the maturation of an already established arteriovenous fistula (AVF) or arteriovenous graft (AVG) or tunneled-cuffed catheter insertion...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/27927601/probiotic-supplementation-in-diabetic-hemodialysis-patients-has-beneficial-metabolic-effects
#18
Alireza Soleimani, Malihe Zarrati Mojarrad, Fereshteh Bahmani, Mohsen Taghizadeh, Mohammad Ramezani, Maryam Tajabadi-Ebrahimi, Parvaneh Jafari, Ahmad Esmaillzadeh, Zatollah Asemi
This study determined the effects of probiotic supplementation on glycemic control, lipid concentrations, biomarkers of inflammation and oxidative stress in 60 diabetic patients on hemodialysis in a parallel randomized double-blind placebo-controlled clinical trial. Participants were initially matched based on sex, duration of dialysis and diabetes, body mass index and age. Subsequently, they were randomly divided into two groups to take either a capsule containing the probiotics Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum or placebo for 12 weeks...
December 4, 2016: Kidney International
https://www.readbyqxmd.com/read/27903478/the-clinical-efficacy-of-balloon-assisted-maturation-of-autogenous-arteriovenous-fistulae
#19
Syed Ali Rizvi, Fred Usoh, Anil Hingorani, Eleanor Iadgarova, Pamela Boniscavage, Justin Eisenberg, Enrico Ascher, Natalie Marks
BACKGROUND: 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 nonmatured AVF has not been explored...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27709092/antegrade-cerebral-perfusion-at-25-%C3%A2-c-for-arch-reconstruction-in-newborns-and-children-preserves-perioperative-cerebral-oxygenation-and-serum-creatinine
#20
Bhawna Gupta, Ali Dodge-Khatami, Juan Tucker, Mary B Taylor, Douglas Maposa, Miguel Urencio, Jorge D Salazar
BACKGROUND: Antegrade cerebral perfusion (ACP) typically is used with deep hypothermia for cerebral protection during aortic arch reconstructions. The impact of ACP on cerebral oxygenation and serum creatinine at a more tepid 25 °C was studied in newborns and children. METHODS: Between 2010 and 2014, 61 newborns and children (<5 years old) underwent aortic arch reconstruction using moderate hypothermia (25.0±0.9 °C) with ACP and a pH-stat blood gas management strategy...
July 2016: Translational pediatrics
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