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Hemodialysis vascular access 2014

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https://www.readbyqxmd.com/read/28663227/national-healthcare-safety-network-nhsn-dialysis-event-surveillance-report-for-2014
#1
Duc B Nguyen, Alicia Shugart, Christi Lines, Ami B Shah, Jonathan Edwards, Daniel Pollock, Dawn Sievert, Priti R Patel
BACKGROUND AND OBJECTIVES: Persons receiving outpatient hemodialysis are at risk for bloodstream and vascular access infections. The Centers for Disease Control and Prevention conducts surveillance for these infections through the National Healthcare Safety Network. We summarize 2014 data submitted to National Healthcare Safety Network Dialysis Event Surveillance. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Dialysis facilities report three types of dialysis events (bloodstream infections; intravenous antimicrobial starts; and pus, redness, or increased swelling at the hemodialysis vascular access site)...
June 29, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28647193/cryopreserved-venous-allograft-is-an-acceptable-conduit-in-patients-with-current-or-prior-angioaccess-graft-infection
#2
Michael P Harlander-Locke, Peter F Lawrence, Aamna Ali, Esther Bae, James Kohn, Christopher Abularrage, Michael Ricci, Gary W Lemmon, Sotero Peralta, Jeffrey Hsu
OBJECTIVE: The durability of cryopreserved allograft has been previously demonstrated in the setting of infection. The objective of this study was to examine the safety, efficacy, patency, and cost per day of graft patency associated with using cryopreserved allograft (vein and artery) for hemodialysis access in patients with no autogenous tissue for native fistula creation and with arteriovenous graft infection or in patients at high risk for infection. METHODS: Patients implanted with cryopreserved allograft for hemodialysis access between January 2004 and January 2014 were reviewed using a standardized, multi-institutional database that evaluated demographic, comorbidity, procedural, and outcomes data...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28603718/impact-of-sleep-apnea-on-in-hospital-outcomes-after-transcatheter-aortic-valve-replacement-insight-from-national-inpatient-sample-database-2011-2014
#3
Ilhwan Yeo, Hasan Ahmad, Wilbert S Aronow
BACKGROUND: Sleep apnea is associated with worse outcomes following various kinds of surgeries. There is a paucity of data on the association of sleep apnea with clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We used National Inpatient Sample (NIS) data 2011-2014 to identify patients undergoing TAVR. Association between sleep apnea and in-hospital postoperative outcomes were assessed by multivariate logistic regression and 1:1 propensity score matching analyses...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28599902/cost-effectiveness-analysis-of-vascular-access-referral-policies-in-ckd
#4
Steven M Shechter, Talon Chandler, M Reza Skandari, Nadia Zalunardo
BACKGROUND: The optimal timing of vascular access referral for patients with chronic kidney disease who may need hemodialysis (HD) is a pressing question in nephrology. Current referral policies have not been rigorously compared with respect to costs and benefits and do not consider patient-specific factors such as age. STUDY DESIGN: Monte Carlo simulation model. SETTING & POPULATION: Patients with chronic kidney disease, referred to a multidisciplinary kidney clinic in a universal health care system...
June 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28553035/brachiocephalic-arteriovenous-fistula-for-hemodialysis-through-the-median-antecubital-vein
#5
E Elamurugan, R Hemachandar
In patients unsuitable for radiocephalic fistula creation, the next option is brachiocephalic fistula. In such patients, we exploited the venous interconnections in the cubital fossa for median cubital vein-Brachiocephalic arteriovenous fistula (AVF) creation. In this article, we describe our experience in the creation of such technical variant of the brachiocephalic fistula AVF, its success and associated complications. A retrospective review of such AVF created between September 2014 and August 2015 was done...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28353491/nonprogrammed-vascular-access-is-associated-with-greater-mortality-in-patients-who-return-to-hemodialysis-with-a-failing-renal-graft
#6
Gustavo Laham, Gervasio Soler Pujol, Antonio Vilches, Ana Cusumano, Carlos Diaz
BACKGROUND: In incident hemodialysis (HD) patients the use of catheters is associated with a worse prognosis when compared to those with an arteriovenous fistula (AVF), but the role of vascular access (VA) type in the morbidity and mortality of patients returning to HD with a failing renal allograft is unknown. We aimed to determine the associations between the type of vascular access and mortality in this population. METHODS: This was a retrospective observational cohort study of 138 patients who initiated dialysis after kidney transplant failure between 1995 and 2014...
March 28, 2017: Transplantation
https://www.readbyqxmd.com/read/28341502/significance-of-blunted-venous-waveforms-seen-on-upper-extremity-ultrasound
#7
Xuan-Binh D Pham, Ezinne J Ihenachor, Hoover Wu, Jerry J Kim, Amy H Kaji, Matthew C Koopmann, Timothy J Ryan, Christian de Virgilio
BACKGROUND: Current guidelines recommend vascular mapping ultrasound (US) prior to arteriovenous fistula creation. Blunted venous waveforms (BVWs) suggest central venous stenosis; however, this relationship and one between BVWs and the presence of a central venous catheter (CVC) remain unclear. METHODS: All patients who received upper extremity vascular mapping US between January 2013 and October 2014 at a single institution were retrospectively reviewed. Patient demographics, comorbidities, US results, pacemaker history, and CVC status were collected...
March 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28325945/surveillance-of-dialysis-events-one-year-experience-at-33-outpatient-hemodialysis-centers-in-china
#8
Hui Zhang, Liuyi Li, Huixue Jia, Yunxi Liu, Jianguo Wen, Anhua Wu, Qun Lu, Tieying Hou, Yun Yang, Huai Yang, Weiguang Li, Zhiyong Zong
A multicenter prospective surveillance on dialysis events was carried in 33 dialysis centers in China. Maintenance hemodialysis (HD) outpatients who were dialyzed on the first two days of each month during 2014 were monitored for dialysis events and other infections. During the one-year period, 52,680 patient-months were monitored. Fistula and tunneled or non-tunneled central line were used for 73.70%, 15.70% and 8.85% of vascular access, respectively. There were 773 dialysis events occurred in 671 patients including 589 IV antimicrobial starts, 74 positive blood cultures and 110 local access site infections (LASI)...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28236920/bovine-carotid-artery-biologic-graft-outperforms-expanded-polytetrafluoroethylene-for-hemodialysis-access
#9
COMPARATIVE STUDY
Isibor Arhuidese, Thomas Reifsnyder, Tasnim Islam, Omar Karim, Besma Nejim, Tammam Obeid, Umair Qazi, Mahmoud Malas
OBJECTIVE: Arteriovenous grafts remain reliable substitutes for permanent hemodialysis access in patients without a suitable autogenous conduit. Advances in conduit design and endovascular management of access-related complications question the preference for synthetic conduits over biologic grafts in contemporary practice. In this study, we compared outcomes between a bovine carotid artery (BCA) biologic graft and expanded polytetrafluoroethylene (ePTFE) grafts for hemodialysis access in a recent cohort of patients...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28135701/catheter-failure-and-mortality-in-hemodialysis-patients-with-tunneled-cuffed-venous-catheters-in-a-single-center
#10
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...
2017: Blood Purification
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28045669/long-term-outcomes-of-successful-endovascular-therapy-via-the-retrograde-approach-for-below-the-knee-chronic-total-occlusion-in-patients-with-critical-limb-ischemia-after-a-failed-antegrade-approach
#12
Junya Matsumi, Takuma Takada, Noriaki Moriyama, Tomoki Ochiai, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Shingo Mizuno, Futoshi Yamanaka, Masato Murakami, Yutaka Tanaka, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVE: This study evaluated long-term results following successful endovascular therapy (EVT) for chronic total occlusion (CTO) below the knee (BTK) using the retrograde approach after a failed antegrade approach. METHODS: Nineteen patients (19 limbs) with critical limb ischemia (CLI) who underwent successful EVT for BTK-CTO using the retrograde approach after a failed antegrade approach during 2010-2014 were studied. RESULTS: Mean duration of the follow-up period was 25...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28031406/complications-of-the-arteriovenous-fistula-a-systematic-review
#13
REVIEW
Ahmed A Al-Jaishi, Aiden R Liu, Charmaine E Lok, Joyce C Zhang, Louise M Moist
The implementation of patient-centered care requires an individualized approach to hemodialysis vascular access, on the basis of each patient's unique balance of risks and benefits. This systematic review aimed to summarize current literature on fistula risks, including rates of complications, to assist with patient-centered decision making. We searched Medline from 2000 to 2014 for English-language studies with prospectively captured data on ≥100 fistulas. We assessed study quality and extracted data on study design, patient characteristics, and outcomes...
June 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#14
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
May 2017: Surgery
https://www.readbyqxmd.com/read/27824950/urgent-start-peritoneal-dialysis-and-hemodialysis-in-esrd-patients-complications-and-outcomes
#15
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/27791257/assessing-radiocephalic-wrist-arteriovenous-fistulas-of-obtuse-anastomosis-using-computational-fluid-dynamics-and-clinical-application
#16
Jinkee Lee, Sunho Kim, Sung-Min Kim, Ryungeun Song, Hyun Kyu Kim, Jang Sang Park, Sun Cheol Park
INTRODUCTION: A radiocephalic arteriovenous fistula (AVF) is the best choice for achieving vascular access (VA) for hemodialysis, but this AVF has high rates of early failure due to juxta-anastomotic stenosis, making it impossible to use for dialysis. Low hemodynamic shear stress contributes to the pathophysiology of VA failure due to secondary thrombosis, stenosis, and re-occlusion after percutaneous intervention. METHODS: We used a computational fluid dynamics (CFDs) approach to evaluate the shear stress distribution and minimize its effects under various conditions including changes in the anastomosis angle...
November 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27699158/outcomes-of-arteriovenous-fistula-for-hemodialysis-in-pediatric-and-adolescent-patients
#17
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha
PURPOSE: This retrospective review aimed to report the outcomes of arteriovenous fistula (AVF) and to evaluate the suitability of AVF as a permanent vascular access in pediatric populations. MATERIALS AND METHODS: Data were collected for all patients aged 0 to 19 years who underwent AVF creation for hemodialysis between January 2000 and June 2014. RESULTS: Fifty-two AVFs were created in 47 patients. Mean age was 15.7±3.2 years and mean body weight was 46...
September 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27669543/impact-of-vascular-access-intervention-therapy-on-cardiac-load-in-hemodialysis-patients
#18
Takayuki Adachi, Tsutomu Sakurada, Takanori Otowa, Keita Uehara, Shina Sueki, Shigeki Kojima, Nagayuki Kaneshiro, Katsuomi Matsui, Tadahisa Tomohiro, Yugo Shibagaki
Vascular access intervention therapy (VAIVT) has been positioned as the first choice of treatment for stenosis lesions frequently observed in arteriovenous fistula (AVF) for hemodialysis patients in Japan. Furthermore, increased blood flow can provide a stable dialysis. In contrast, it has been reported that excess blood flow of AVF causes high-output heart failure. Although VAIVT is used to increase blood flow of AVF, the impact of VAIVT on cardiac load has been rarely reported. We examined the factors associated with cardiac load in hemodialysis patients undergoing VAIVT by measuring levels of α human atrial natriuretic polypeptide (hANP) and brain natriuretic peptide (BNP) before and after VAIVT...
October 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27601144/usefulness-of-paclitaxel-releasing-high-pressure-balloon-associated-with-cutting-balloon-angioplasty-for-treatment-of-outflow-stenoses-of-failing-hemodialysis-arteriovenous-shunts
#19
Anna Maria Ierardi, Marco Franchin, Federico Fontana, Gabriele Piffaretti, Ejona Duka, Massimo Tonolini, Vittorio Miele, Matteo Tozzi, Gianpaolo Carrafiello
AIM: To evaluate the technical and clinical success, primary patency (PP) and complications of angioplasty performed with paclitaxel-coated balloon (PCBs) associated with cutting balloon and for the treatment of the outflow stenoses of failing hemodialysis arteriovenous shunt. MATERIAL AND METHODS: From September 2014 to September 2015, 50 patients with 66 stenoses were registered. Vascular accesses were autogenous (n = 20) and prosthetic (n = 30). Stenosis were documented during follow-up with routine echo-color Doppler, clinical evaluation and in the remaining incidentally during fistulography...
January 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/27398601/recurrent-vascular-access-dysfunction-as-a-novel-marker-of-cardiovascular-outcome-and-mortality-in-hemodialysis-patients
#20
Hyo Jin Kim, Hajeong Lee, Dong Ki Kim, Kook-Hwan Oh, Yon Su Kim, Curie Ahn, Jin Suk Han, Seung-Kee Min, Sang-Il Min, Hyo-Cheol Kim, Kwon Wook Joo
BACKGROUND: Vascular access (VA) is essential for hemodialysis (HD) patients, and its dysfunction is a major complication. However, little is known about outcomes in patients with recurrent VA dysfunction. We explored the influence of recurrent VA dysfunction on cardiovascular (CV) events, death and VA abandonment. METHODS: This is a single-center, retrospective study conducted in patients who underwent VA surgery between 2009 and 2014. VA dysfunction was defined as VA stenosis or thrombosis requiring intervention after the first successful cannulation...
2016: American Journal of Nephrology
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