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https://www.readbyqxmd.com/read/29148006/autogenous-forearm-loop-arteriovenous-fistula-creation
#1
Weng Jun Tang, Arman Zaharil Mat Saad
INTRODUCTION: Arteriovenous fistula is a lifeline for end-stage kidney disease patients on dialysis. The quality of the vein and artery to be used plays a crucial role in attaining a functioning, reliable and long-lasting arteriovenous fistula. The aim of the study is to present an alternative for haemodialysis access to preserve the upper arm vasculature for future use - the forearm loop arteriovenous fistula. METHODS: From October 2015 to September 2016, 202 patients with chronic kidney disease (CKD), stages 4 and 5, underwent arteriovenous fistula creation at the Universiti Sains Malaysia Hospital, Malaysia...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148005/microsurgery-for-wrist-arteriovenous-fistula-creation-in-children-a-retrospective-cohort-study
#2
Afram Akturk, Roel Bakx, Michiel J S Oosterveld, Jim C H Wilde, Mirza M Idu
INTRODUCTION: Creating functional arteriovenous fistulae (AVF) at the wrist is challenging in paediatric patients because of the small calibre of the blood vessels. METHODS: We report our experience with AVF surgery in children younger than 15 years of age using microsurgical techniques. Twenty-five patients underwent AVF surgery between 2003 and 2015 (20 for haemodialysis, 4 for plasmapheresis and 1 for parenteral nutrition). Median (range) age was 9 (2-15) years and median weight was 24 (8-61) kg...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#3
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29142271/structural-and-functional-differences-in-gut-microbiome-composition-in-patients-undergoing-haemodialysis-or-peritoneal-dialysis
#4
Vanessa Stadlbauer, Angela Horvath, Werner Ribitsch, Bianca Schmerböck, Gernot Schilcher, Sandra Lemesch, Philipp Stiegler, Alexander R Rosenkranz, Peter Fickert, Bettina Leber
Complications of end-stage renal disease (ESRD) are critically related to inflammation. The gut microbiome is a key driver of inflammation. Since dialysis modalities may differently influence the gut microbiome, we aimed to compare the effects of haemodialysis (HD) and peritoneal dialysis (PD) on patients' gut microbiome composition and function. We therefore studied faecal microbiome composition and function as well as inflammation and gut permeability in 30 patients with ESRD (15 HD, 15 PD) and compared to 21 healthy controls...
November 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29139052/a-validated-patient-specific-fsi-model-for-vascular-access-in-haemodialysis
#5
A M de Villiers, A T McBride, B D Reddy, T Franz, B S Spottiswoode
The flow rate inside arteriovenous fistulas is many times higher than physiological flow and is accompanied by high wall shear stress resulting in low patency rates. A fluid-structure interaction finite element model is developed to analyse the blood flow and vessel mechanics to elucidate the mechanisms that can lead to failure. The simulations are validated against flow measurements obtained from magnetic resonance imaging data.
November 14, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#6
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136192/assessing-the-hydration-status-of-children-with-chronic-kidney-disease-and-on-dialysis-a-comparison-of-techniques
#7
Caroline S Y Eng, Devina Bhowruth, Mark Mayes, Lynsey Stronach, Michelle Blaauw, Amy Barber, Lesley Rees, Rukshana C Shroff
Background: Fluid balance is pivotal in the management of children with chronic kidney disease (CKD) and on dialysis. Although many techniques are available to assess fluid status, there are only a few studies for children, of which none have been comparable against cardiovascular outcome measures. Methods: We performed a longitudinal study in 30 children with CKD5-5D and 13 age-matched healthy controls (71 measurements) to determine a correlation between optimal weight by bioimpedance spectroscopy (Wt-BIS) and clinical assessment (Wt-CA)...
November 9, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29133076/comparison-of-the-hemodynamic-tolerance-and-the-biological-parameters-of-four-acetate-free-hemodialysis-methods
#8
George Kosmadakis, Enrique Da Costa Correia, Julie Albaret, Frédéric Somda, Didier Aguilera
PURPOSE: Acetate in hemodialysis solutions exerts inflammatory, vasodilatatory and cardio-depressive effects. Citrate has been proposed as an optimal substitute. The aim of the present trial was the comparison of the hemodynamic and biological parameters on a group of patients dialysed consecutively with 4 acetate-free haemodialysis techniques. METHODS: In a prospective crossover manner, we measured the hemodynamic and biological effects of four acetate-free hemodialysis methods: he acetate-free biofiltration with variable potassium (AFBK) and three methods with a citrate buffer: onventional hemodialysis (HD), on-line hemodiafiltration (HDF) and on-line hemofiltration (HF)...
November 10, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29129386/atrial-fibrillation-in-patients-on-haemodialysis-in-andalusia-prevalence-clinical-profile-and-therapeutic-management
#9
Carmen Sánchez Perales, Teresa Vázquez Sánchez, Daniel Salas Bravo, Sonia Ortega Anguiano, Eduardo Vázquez Ruiz de Castroviejo
Atrial fibrillation (AF) represents an important social and healthcare problem. There is wide variability in the prevalence of this arrhythmia in studies analysing patients on haemodialysis (HD). OBJECTIVE: To investigate the prevalence, clinical profile and therapeutic management of patients with AF on HD in Andalusia. METHODS: We asked the public healthcare system of Andalusia to provide us with the number of patients who were being treated with HD. We asked attending nephrologists from all hospital and outpatient centres in 5 of the 8 Andalusian provinces to perform an electrocardiogram and to fill out a questionnaire on patients selected by simple random sampling...
November 9, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29126841/-exercise-as-a-protective-cardiovascular-and-metabolic-factor-in-end-stage-renal-disease-patients
#10
Myriam Isnard-Rouchon, Céline Coutard
OBJECTIVE: The aim of the study was to test the effectiveness of Physical Activity (PA) during haemodialysis as a protective treatment against cardiovascular (CV) diseases. METHODS: Eighty volunteer patients were included in this multicentric prospective study and followed for two years: 40 patients in the Exercise group (EX), 40 patients in the Control group (Ctrl). CV risk factors: Total Cholesterol, HDL Cholesterol (HDL-c), LDL cholesterol (LDL-c), Triglycerides (TG) and Hemoglobin (Hb), and Prealbumin, Albumin, Parathormon, 25-OH Vitamin D, were checked at Month 0 (M0) and Month 24 (M24)...
November 7, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29122896/persistent-bacteraemia-caused-by-staphylococcus-aureus-in-the-gall-bladder
#11
Alexander Tin Han Yu, Tony Cun, Esther Benamu, Cybele Renault
Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29122793/developing-a-classification-system-for-haemoglobin-management-in-patients-with-end-stage-renal-disease-on-haemodialysis-a-secondary-data-analysis
#12
Tibor Kesztyüs, Ulrich Simonsmeier, Dorothea Kesztyüs
BACKGROUND: Ongoing discussion on anaemia management and target haemoglobin (Hb) levels in patients on haemodialysis with erythropoietin treatment require a systematic approach in evaluating current practice. Aim of the present study was to develop a new classification system to easily monitor Hb trajectories and categorise patients on haemodialysis. METHODS: Routine data from five dialysis centres in the USA collected between 2010 and 2016. Data were anonymised and only those from patients with fortnightly Hb values were included in the analysis...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122211/citrate-dialysate-does-not-induce-oxidative-stress-or-inflammation-in-vitro-as-compared-to-acetate-dialysate
#13
Rafael Pérez-García, Rafael Ramírez Chamond, Patricia de Sequera Ortiz, Marta Albalate, Marta Puerta Carretero, Mayra Ortega, M Caridad Ruiz Caro, Roberto Alcazar Arroyo
Increased acetataemia during haemodialysis sessions has been associated with a number of abnormalities, including increased oxidative stress, pro-inflammatory cytokines and nitric oxide synthesis. However, citric acid may play an alternative role to acetate as a dialysate stabiliser given that the effect of citrate on complement and leukocyte activation is different to that of acetate. The purpose of this study was to compare the inflammatory effect in immunocompetent blood cells of acetate dialysate and citrate dialysate...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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/29121886/the-strange-case-of-mr-h-starting-dialysis-at-90%C3%A2-years-of-age-clinical-choices-impact-on-ethical-decisions
#15
Giorgina Barbara Piccoli, Andreea Corina Sofronie, Jean-Philippe Coindre
BACKGROUND: Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. CASE PRESENTATION: Mr...
November 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29117741/%C3%AE-thromboglobulin-may-not-reflect-platelet-activation-during-haemodialysis-with-the-hepran-membrane
#16
Solbjørg Sagedal, Leiv Sandvik, Olav Klingenberg, Per Morten Sandset
BACKGROUND: When blood passes through the extracorporeal circuit during haemodialysis (HD) undesirable effects including platelet degranulation and coagulation activation take place. β-thromboglobulin (β-TG) is a sensitive marker of platelet activation. The aim of this study was to investigate platelet degranulation and coagulation activation during HD with the heparin-coated dialysis membrane HeprAN. METHODS: Four HD sessions were evaluated in each of 12 chronic HD patients...
December 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29113907/assessing-the-prevalence-of-protein-energy-wasting-in-haemodialysis-patients-a-cross-sectional-monocentric-study
#17
Rajaa Essadik, Rajaa Msaad, Halima Lebrazi, Hassan Taki, El Hassane Tahri, Anass Kettani, Ghizlane Madkouri, Benyounes Ramdani, Rachid Saïle
INTRODUCTION: Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in haemodialysis (HD) patients. However, there is no consensus for its assessment. The present study aimed to assess the nutritional status of patients on chronic HD by use of different nutritional assessment parameters, and at verifying which can identify the greatest number of HD patients with PEW. Also, to investigate predictors of nutritional status in a haemodialysis center in Morocco...
November 4, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#18
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/29102271/prevalence-of-malnutrition-inflammation-complex-syndrome-and-its-correlation-with-thyroid-hormones-in-chronic-haemodialysis-patients
#19
Venice Chávez Valencia, Oliva Mejía Rodríguez, Martha Eva Viveros Sandoval, Juan Abraham Bermúdez, Sergio Gutiérrez Castellanos, Citlalli Orizaga de la Cruz, Martha Alicia Roa Córdova
INTRODUCTION: Low levels of thyroid hormones, total triiodothyronine (T3) and free triiodothyronine (FT3) in haemodialysis patients is a marker of malnutrition and inflammation and are predictors of mortality. The aim of this study was to determine the prevalence of malnutrition-inflammation complex syndrome in haemodialysis and its relationship with the thyroid hormones thyrotropin, T3, FT3 and free thyroxine (FT4), as well as to evaluate the prevalence of low FT3 syndrome and its correlation with nutritional and inflammatory markers...
October 25, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29097485/increased-inflammatory-response-in-association-with-the-initiation-of-hemodialysis-compared-with-peritoneal-dialysis-in-a-prospective-study-of-end-stage-kidney-disease-patients
#20
Yong Kenneth, Gursharan Dogra, Neil C Boudville, Wai H Lim
BACKGROUND: Large epidemiological studies have demonstrated an early survival advantage with the initiation of peritoneal dialysis (PD) compared to haemodialysis (HD). Chronic inflammation may contribute to atherosclerosis and cardiovascular (CVD) mortality in end-stage kidney disease (ESKD). We hypothesize that the initiation of HD in ESKD patients is associated with a greater inflammatory response compared with PD. AIMS: To examine the effects of initiating HD and PD upon inflammation and CVD risk markers in ESKD patients...
November 2, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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