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Non-tunneled hemodialysis catheters

Chih-Hao Chang, Myo-Ming Huang, Dong-Feng Yeih, Kuo-Cheng Lu, Yi-Chou Hou
BACKGROUND: Isolated pulmonary valve infective endocarditis caused by Candida is rare in chronic hemodialysis patients. The 2009 Infectious Diseases Society of America guidelines suggest the combined use of surgery and antibiotics to treat candidiasis; however, successful nonsurgical treatment of Candida endocarditis has been reported. CASE PRESENTATION: A 63-year-old woman with end-stage kidney disease was admitted to our hospital after experiencing disorientation for 5 days...
September 6, 2017: BMC Nephrology
Ya-Ting Huang, Yu-Ming Chang, I-Ling Chen, Chuan-Lan Yang, Show-Chin Leu, Hung-Li Su, Jsun-Liang Kao, Shih-Ching Tsai, Rong-Na Jhen, Woung-Ru Tang, Chih-Chung Shiao
BACKGROUND: Vascular access (VA) is the lifeline of hemodialysis patients. Although the autonomic nervous system might be associated with VA failure (VAF), it has never been addressed in previous studies. This study aimed to evaluate the predictive values of the heart rate variability (HRV) indices for long-term VA outcomes. METHODS: This retrospective study was conducted using a prospectively established cohort enrolling 175 adult chronic hemodialysis patients (100 women, mean age 65...
2017: PloS One
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
Manish Rathi, Venkata Siva Tez Pinnamaneni, Vinay Sakhuja
BACKGROUND: Absolute necessity in acute kidney injury (AKI) and ignorance in chronic kidney disease (CKD) make the use of un-cuffed, non-tunneled catheters an indispensable vascular access for hemodialysis. Although these catheters should be inserted under radiological guidance, it may not be feasible in certain circumstances. The aim of the present study was to evaluate safety and outcome of non-imaging assisted insertion of these catheters in internal jugular vein (IJV) for hemodialysis...
August 2016: Biomedical Journal
Franklin Correa Barcellos, Bruno Pereira Nunes, Luciana Jorge Valle, Thiago Lopes, Bianca Orlando, Cintia Scherer, Marcia Nunes, Gabriela Araújo Duarte, Maristela Böhlke
BACKGROUND: Central venous catheters (CVC) are the only option when hemodialysis is needed for patients without definitive vascular access. However, CVC is associated with complications, such as infection, thrombosis, and dysfunction, leading to higher mortality and expenditures. The aim of this study was to compare the effectiveness of 30 % trisodium citrate (TSC30 %) with heparin as CVC lock solutions in preventing catheter-related bloodstream infections (CRBSI) and dysfunction in hemodialysis patients...
April 2017: Infection
Jakob Gubensek, Matej Zrimsek, Vladimir Premru, Jadranka Buturovic-Ponikvar, Rafael Ponikvar
The choice of vascular access in very elderly hemodialysis patients can be complex. Data on the frequency of interventions and complications when temporary catheters are used for long periods in this population are lacking. All incident patients ≥80 years old, dialyzed over non-tunneled catheters, were included and the frequency of interventions (re-insertions and wire-exchanges) and complications (catheter-related blood stream infections) were recorded. In 31 patients aged 84 ± 4 years, dialyzed for 1...
June 2016: Therapeutic Apheresis and Dialysis
Deborah M Stupak, Jennifer A Trubilla, Susann R Groller
In an attempt to create a standardized resource for cleansing both non-tunneled and tunneled hemodialysis catheters, it was discovered that all disinfectants are not compatible with all catheters. This article describes the process used to identify best practices for hemodialysis catheter care and steps taken to standardize practice throughout a hospital network. Standardized evidence-based practice preserves the integrity of catheters while allowing nurses to provide quality care to patients.
March 2016: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Hu Chen, De-Guang Wang, Liang Yuan, Gui-Ling Liu, Heng-Jie He, Juan Wang, Sen Zhang, Li Hao
BACKGROUND: The incidence of diabetic nephropathy (DN) increases year by year. However, clinical characteristics of DN patients on maintenance hemodialysis (MHD) were rarely reported in China. The purpose of this study was to examine the clinical characteristics of the DN patients on MHD in Anhui Province, Eastern China. METHODS: The clinical data of MHD patients in the hemodialysis centers of 26 hospitals in Anhui Province from January 1, 2014, to March 31, 2014, were examined...
June 5, 2016: Chinese Medical Journal
Yoo Hyung Kim, Hae Ri Kim, Hong Jae Jeon, Ye-Jin Kim, Sa Ra Jung, Dae Eun Choi, Kang Wook Lee, Ki Ryang Na
BACKGROUND/AIMS: Fragmented care in nephrology can cause treatment delays. Nephrologists are qualified to perform vascular access-related procedures because they understand the pathophysiology of renal disease and perform physical examination for vascular access. We compared treatment delays associated with tunneled hemodialysis catheter (TDC) placement between interventional radiologists and nephrologists. METHODS: We collected data by radiologists from January 1, 2011 through December 31, 2011 and by nephrologists from since July 1, 2012 through June 30, 2013...
May 2016: Korean Journal of Internal Medicine
Ramon Roca-Tey
Heart failure (HF) is the most frequent cardiovascular disease associated with chronic kidney disease and represents a high risk for cardiovascular mortality in incident hemodialysis (HD) patients. This risk is especially high during the arteriovenous fistula (AVF) maturation period due to the marked hemodynamic changes related to the large increase in the blood flow and also within the first 120 days after HD inception because in this period the highest mortality rate occurs. When planning the vascular access for each incident HF patient, the risk of aggravating HF after AVF creation must be evaluated carefully alongside the risk of catheter-related complications, but avoiding a non-selective 'catheter first' approach for all these patients...
March 2016: Journal of Vascular Access
Edward G Clark, Ayub Akbari, Brett Hiebert, Swapnil Hiremath, Paul Komenda, Charmaine E Lok, Louise M Moist, Michael E Schachter, Navdeep Tangri, Manish M Sood
BACKGROUND: Non-tunneled (temporary) hemodialysis catheters (NTHCs) are the least-optimal initial vascular access for incident maintenance hemodialysis patients yet little is known about factors associated with NTHC use in this context. We sought to determine factors associated with NTHC use and examine regional and facility-level variation in NTHC use for incident maintenance hemodialysis patients. METHODS: We analyzed registry data collected between January 2001 and December 2010 from 61 dialysis facilities within 12 geographic regions in Canada...
February 27, 2016: BMC Nephrology
Ks Amitha Vikrama, N Srivalli, Raju S Venkataramana
The incidence of end-stage renal disease is significantly increasing and most patients who require renal transplantation are undergoing hemodialysis through tunneled/non-tunneled dialysis catheters and arteriovenous fistulas. The greatest disadvantage of the hemodialysis access is the limited durability of the arteriovenous fistulas and grafts, which, on average, remain patent for <3 years, but are the lifeline for hemodialysis patients. Catheter-directed interventions are successful in re-establishing flow in more than 80% of thrombosed hemodialysis fistulas and have become the treatment of choice for failing or thrombosed accesses...
July 2015: Indian Journal of Radiology & Imaging
Timothy W I Clark, Jonas W Redmond, Mark P Mantell, Gregory J Nadolski, Jeffrey I Mondschein, Michael F Dowd, Mandeep S Dagli, Deepak Sudheendra, Richard D Shlansky-Goldberg, Raphael D Cohen
PURPOSE: To report preliminary clinical experience with a new symmetric-tip dialysis catheter compared with a conventional split-tip catheter. MATERIALS AND METHODS: Over a 5-month period, patients requiring a tunneled catheter for hemodialysis or undergoing exchange of a dysfunctional dialysis catheter at a tertiary academic medical center were retrospectively analyzed. Patients underwent placement of a VectorFlow or Ash Split Cath catheter at the discretion of the inserting interventional radiologist...
October 2015: Journal of Vascular and Interventional Radiology: JVIR
Jin Suk Kang, Hee Ryeong Jang, Jeong Eun Lee, Young Joo Park, Harin Rhee, Eun Young Seong, Ihm Soo Kwak, Il Young Kim, Dong Won Lee, Soo Bong Lee, Sang Heon Song
BACKGROUND: The bacterial colonization of hemodialysis catheter occurs frequently and reaches to the catheter-related bloodstream infections (CRBSIs). We hypothesized bacterial colonization promotes inflammation and that might be associated with renal outcome. The aim of this study was to investigate the colonization status for tunneled cuffed dialysis catheter (TCC) and the factors for contributing to the catheter colonization and explore whether bacterial colonization would be related with declining of residual renal function (RRF)...
April 2016: Clinical and Experimental Nephrology
Tibor Fülöp, Betzaida Rodríguez, Béla A Kosztaczky, Kamel A Gharaibeh, Zsolt Lengvárszky, Neville R Dossabhoy, Mihály B Tapolyai
Bedside removal of tunneled hemodialysis catheters (TDC) by noninterventional Nephrologists has not been frequently performed or studied. We performed a retrospective review of bedside TDC removal at the University of Mississippi Medical Center between January, 2010 and June, 2013. We collected data on multiple patients and procedure-related variables, success, and complications rates. Of the 138 subjects, mean age was 50 (±15.9) years, 49.3% were female, 88.2% African American and 41% diabetics. Site of removal was the right internal jugular (IJ) in 76...
September 2015: Seminars in Dialysis
Francois Folefack Kaze, Gloria Ashuntantang, Marie Patrice Halle, Andre-Pascal Kengne
The aim of the present study was to investigate the adverse outcomes of non-tunneled hemodialysis catheters and determinants in chronic hemodialysis patients receiving care at the Yaoundé General Hospital hemodialysis center, Cameroon. This was a prospective study of 11 months duration (February-December 2008) involving 81 non-tunneled non-cuffed catheters (63 femoral, 18 internal jugular) placed in 72 adults (47 men, 65.3%) on chronic hemodialysis. Baseline clinical and laboratory parameters associated with catheter-related complications during follow-up were investigated...
October 2014: Therapeutic Apheresis and Dialysis
Sara C Fallon, Michael E Kim, Caraciolo J Fernandes, Sanjeev A Vasudevan, Jed G Nuchtern, Eugene S Kim
BACKGROUND: Hospitalized infants>1 y old often require central venous catheters (CVC) for prolonged therapy. There are limited data describing the complication profile for this young population. The purpose of this study was to review outcomes associated with CVC insertion in this high-risk group and compare them to those in older children to develop directed quality improvement projects. MATERIALS AND METHODS: Patients receiving their first CVC, a tunneled central line or port-a-cath, from 2007-2010 were included...
July 2014: Journal of Surgical Research
Fatina I Fadel, Manal F Elshamaa, Marwa M Nabhan, Rascha G Essam, Nagwa Kantoush, Marwa M El Sonbaty, Mona Raafat, Dalia A Abd-El Haleem
Vascular access represents a lifeline for children undergoing hemodialysis. A failure of vascular access among patients receiving regular hemodialysis is associated with increased morbidity, mortality and costs. We assessed the possibility of using soluble adhesion molecules as reliable predictors of vascular access failure in children on hemodialysis. Moreover, we evaluated whether there is an association among the different studied adhesion molecules in hemodialysis patients with thrombosed and non-thrombosed arteriovenous fistula fistulas (AVFs)...
October 2014: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Edward G Clark, Jeffrey H Barsuk
The insertion of non-tunneled temporary hemodialysis catheters (NTHCs) is a core procedure of nephrology practice. While urgent dialysis may be life-saving, mechanical and infectious complications related to the insertion of NTHCs can be fatal. In recent years, various techniques that reduce mechanical and infectious complications related to NTHCs have been described. Evidence now suggests that ultrasound guidance should be used for internal jugular and femoral vein NTHC insertions. The implementation of evidence-based infection-control 'bundles' for central venous catheter insertions has significantly reduced the incidence of bloodstream infections in the intensive care unit setting with important implications for how nephrologists should insert NTHCs...
November 2014: Kidney International
Elizabeth C Evans, Debra Hain, Tamara M Kear, Leslie A Dork, Christine Schrauf
This six-month prospective, multi-site study incorporated no dressing coverage over hemodialysis central venous catheter exit sites and compared the outcomes of two groups of patients receiving incenter hemodialysis: a shower group and a non-shower group. Outcomes included exit site infection rates, tunnel infection rates, and catheter-related bloodstream infection rates. The study enrolled 40 patients--31 patients in the shower group and nine patients in the non-shower group. The study was initially designed as a randomized controlled study, but after a month of enrolling patients, most patients insisted on being in the shower group...
January 2014: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
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