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Vascular access for hemodialysis

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https://www.readbyqxmd.com/read/29662810/clinical-results-of-arteriovenous-fistulas-constructed-using-autologous-vessels-in-end-stage-renal-disease-patients-on-hemodialysis
#1
Ki Tae Kim, Jae Wook Ryu, Pil Won Seo, Kyoung Min Ryu
Background: For hemodialysis patients with end-stage renal disease (ESRD), it is important to construct an efficient vascular access with a superior patency rate. This study investigated the factors influencing the efficiency of arteriovenous fistulas (AVFs) constructed using an autologous vessel and evaluated the necessity of ultrasonography as a preoperative tool for AVF construction. Methods: A retrospective analysis was performed of 250 patients in whom an AVF was constructed using an autologous vessel due to ESRD at our institution from January 2009 to April 2016...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29657207/adoption-of-transposed-basilic-vein-as-access-for-hemodialysis
#2
Jacob A Akoh
The fistula first initiative has rekindled interest in transposition of basilic vein (TBV) in preference to arteriovenous grafts (AVG). TBV is considered to have advantages over AVG. The aim of this study was to analyze the outcome of TBVs in our center comparing them to a historically matched group of patients who had AVG. Thirty-two patients who underwent TBV as a vascular access procedure in Derriford Hospital between January 2010 and October 2014 were included in the study. The historical control group comprised 31 patients who had AVG inserted in the upper arm between January 1999 and December 2010...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29656848/the-discipline-of-epidemiology-engaging-in-the-full-breadth-of-population-health-science
#3
EDITORIAL
Harold I Feldman
This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology...
March 21, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29629274/current-characteristics-of-dialysis-therapy-in-korea-2016-registry-data-focusing-on-diabetic-patients
#4
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park, Yong-Kyun Kim
Diabetic nephropathy is the most frequent cause of end-stage renal disease worldwide. Dialysis patients with diabetes mellitus (DM) have more complications and shorter survival duration than non-DM dialysis patients, requiring more clinical attention and difficult management. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an on-line registry program and analyzed the characteristics of patients. A survey of dialysis patients in 2016 showed that 50...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29629273/korean-clinical-practice-guidelines-for-preventing-the-transmission-of-infections-in-hemodialysis-facilities
#5
Hayne Cho Park, Young-Ki Lee, Kyung Don Yoo, Hee Jung Jeon, Seung Jun Kim, Ajin Cho, Jacob Lee, Yang-Gyun Kim, Sang-Ho Lee, Sang-Oh Lee
Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential infections, each hemodialysis unit should establish and follow standard infection control and prevention measures. Therefore, clinical practice guidelines were developed by a working group of nephrologists and infection control specialists to provide evidence-based guidance for dialysis physicians and nurses, with the aim of preventing infection transmission and controlling infection sources in hemodialysis facilities...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29627998/physical-examination-of-the-hemodialysis-arteriovenous-fistula-to-detect-early-dysfunction
#6
Kenneth Abreo, Bakhtiar M Amin, Adrian P Abreo
The maintenance of vascular access patency for end-stage renal disease patients on hemodialysis is necessary for survival. Many nephrologists, nurse practitioners, and nurses have limited experience with the physical examination of the arteriovenous fistula. In this review, we define key terms used in the assessment of an arteriovenous fistula. We discuss the arteriovenous fistula physical exam, including details of inspection, palpation, and auscultation. Using these concepts, we review the abnormal findings that can assist practitioners in determining the location of a stenosis...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29622355/a-prospective-randomized-study-of-stent-graft-placement-after-balloon-angioplasty-versus-balloon-angioplasty-alone-for-the-treatment-of-hemodialysis-patients-with-prosthetic-graft-outflow-stenosis
#7
Hsuan-Tzu Yang, Sheng-Yueh Yu, Ta-Wei Su, Tsung-Chi Kao, Hung-Chang Hsieh, Po-Jen Ko
BACKGROUND: Hemodialysis graft outflow stenosis is a significant complication occurring in hemodialysis patients with prosthetic grafts for vascular access. Balloon angioplasty remains the first-line endovascular treatment of this complication, although covered stent graft implantation after balloon angioplasty also appears to be an effective and promising treatment. The aim of this study was to evaluate the efficacy and durability of stent graft placement after balloon angioplasty in comparison to balloon angioplasty alone for the treatment of graft outflow stenosis in hemodialysis patients...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29618823/oxygen-extraction-ratio-oer-as-a-measurement-of-hemodialysis-hd-induced-tissue-hypoxia-a-pilot-study
#8
Silverio Rotondi, Lida Tartaglione, Maria Luisa Muci, Alessio Farcomeni, Marzia Pasquali, Sandro Mazzaferro
HD tissue hypoxia associates with organ dysfunctions. OER, the ratio between SaO2 and central-venous-oxygen-saturation, could estimate oxygen requirements during sessions, but no data are available. We evaluated OER behavior in 20 HD patients with permanent central venous catheter (CVC) as vascular access. Pre-HD OER (33.6 ± 1.4%; M ± SE) was higher than normal (range 20-30%). HD sessions increased OER to 39.2 ± 1.5% (M ± SE; p < 0.05) by 30' and to 47.4 ± 1.5% (M ± SE; p < 0...
April 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29615168/reasons-for-removal-of-non-tunneled-double-lumen-catheters-in-incident-dialysis-patients
#9
Ruqaya Qureshi, Beena Salman, Salman Imtiaz, Murtaza F Drohlia, Aasim Ahmad
OBJECTIVE: To evaluate the reasons of removal of non-tunneled double lumen catheters (NTDLC) in incident hemodialysis (HD) patients in a tertiary renal care hospital. STUDY DESIGN: Observational retrospective study. PLACE AND DURATION OF STUDY: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKC PGTI), Karachi, from June 2015 to May 2016. METHODOLOGY: All patients were selected who had naive NTDLC placement at TKC PGTI either in Emergency Room (ER) or Intensive Care Unit (ICU) during the study period...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29605379/bacteriology-of-the-buttonhole-cannulation-tract-in-hemodialysis-patients-a-prospective-cohort-study
#10
Line Dahlstrøm Christensen, Mai-Britt Skadborg, Agnete H Mortensen, Carsten Mortensen, Jens K Møller, Lars Lemming, Irene Høgsberg, Steffen E Petersen, Niels H Buus
BACKGROUND: The buttonhole cannulation technique for arteriovenous fistulas is widely used, but has been associated with an increased rate of vascular access-related infections. We describe the frequency and type of bacterial colonization of the buttonhole tract over time and associated clinical infections. STUDY DESIGN: A prospective observational cohort study with 9 months of follow-up. SETTING & PARTICIPANTS: 84 in-center hemodialysis patients using the buttonhole cannulation technique at 2 Danish dialysis centers...
March 29, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29602630/medicare-costs-associated-with-arteriovenous-fistulas-among-us-hemodialysis-patients
#11
Mae Thamer, Timmy C Lee, Haimanot Wasse, Marc H Glickman, Joyce Qian, Daniel Gottlieb, Scott Toner, Timothy A Pflederer
BACKGROUND: An arteriovenous fistula (AVF) is the recommended vascular access for hemodialysis (HD). Previous studies have not examined the resources and costs associated with creating and maintaining AVFs. STUDY DESIGN: Retrospective observational study. SETTING & PARTICIPANTS: Elderly US Medicare patients initiating hemodialysis therapy during 2010 to 2011. PREDICTOR: AVF primary and secondary patency and nonuse in the first year following AVF creation...
March 28, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29597214/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvement
#12
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29588811/effect-of-low-dose-aspirin-and-dipyridamole-on-primary-patency-of-arteriovenous-grafts-in-hemodialysis-patients-a-randomized-double-blind-placebo-controlled-trial
#13
Pouya Tayebi, Gholamhosein Kazemzadeh, Azin Banihashem, Hassan Ravari
Background: There is some evidence for the efficacy of antiplatelet therapies in increasing the vascular access patency duration or decreasing the thrombosis of arteriovenous grafts. Objective: To determine the effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients. Methods: This randomized, double-blind, placebo-controlled trial was done at Imam Reza Hospital in Mashhad, Iran from September 10, 2015 to July 05, 2016...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29572627/functional-impairment-and-risk-of-mortality-in-patients-on-chronic-hemodialysis-results-of-the-lazio-dialysis-registry
#14
Maurizio Bossola, Claudia Marino, Anteo Di Napoli, Nera Agabiti, Luigi Tazza, Marina Davoli
BACKGROUND: Functional impairment is associated with adverse outcomes in older people, as well as in patients on chronic hemodialysis. The aim of this study was to evaluate if functional impairment represents a risk factor for reduced survival in patients on chronic hemodialysis. METHODS: All incident chronic hemodialysis patients of Lazio, a large region of central Italy, registered in the Dialysis and Transplant Lazio Region Registry (DTLRR) in the period 2008-2013 were considered eligible...
March 23, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29571619/predictive-factors-of-recurrent-endovascular-intervention-for-cephalic-arch-stenosis-after-percutaneous-transluminal-angioplasty
#15
Marta Neves, Cristina Outerelo, Marta Pereira, Fernando Neves, Telmo Carvalho, Pedro Maia, Pedro Ponce
OBJECTIVE: Cephalic arch stenosis (CAS) is an important and recurring problem arising in hemodialysis patients because of the requirement for repeated interventions to maintain patency. The aim of this study was to determine predictive factors for recurrence of CAS after successful angioplasty. METHODS: A retrospective, case-control study was conducted at two ambulatory vascular access (VA) centers. All patients with a dysfunctional VA referred for an angiographic procedure and with a documented CAS as evidenced during the endovascular intervention (EI) between January 1, 2013, and December 31, 2015, were enrolled; 15 patients in whom an efficacious intervention was not possible were excluded...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29567027/a-prospective-randomized-study-of-bovine-carotid-artery-biologic-graft-and-expanded-polytetrafluoroethylene-for-permanent-hemodialysis-access
#16
Hanaa Dakour Aridi, Isibor Arhuidese, Melissa Scudder, Thomas Reifsnyder, Mahmoud B Malas
OBJECTIVE: Arteriovenous grafts (AVGs) remain reliable substitutes for permanent hemodialysis access in scenarios that preclude the placement of native arteriovenous fistulas (AVFs). The majority of AVGs are constructed of expanded polytetrafluoroethylene (ePTFE), which is relatively inexpensive and readily available, but synthetic AVGs have poor patency rates. On the other hand, biologic grafts confer an advantage by virtue of their inherent similarity to the native human vasculature...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29562822/vascular-mapping-for-the-decision-of-hemodialysis-access-method-case-report
#17
Takashi Uchino, Hiromasa Nakai, Hiroaki Ichihashi, Tsukasa Sasaki, Nakanobu Azuma
Preoperative ultrasound vascular mapping was performed to determine the surgical method for two cases where standard arteriovenous fistula was not possible. In case 1, the previous arteriovenous fistula of the left arm was occluded, and arteriovenous graft of the right arm was thrombosed after frequent percutaneous transluminal angioplasty. Contrast medium was contraindicated because of allergy. Using preoperative ultrasound vascular mapping, we were able to establish the appropriate surgical method. In case 2, hemodialysis was started by catheter insertion, and then access creation was planned...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29560785/endovascular-bypass-for-salvage-of-vascular-access-in-hemodialysis-catheter-consigned-patients
#18
Matt Chiung-Yu Chen, Mei-Jui Weng, Huei-Lung Liang
PURPOSE: This study was performed to retrospectively assess the efficacy of percutaneous creation of an intervascular bypass with or without stent graft deployment (endovascular bypass) for salvage of abandoned vascular access sites in hemodialysis catheter-consigned patients. METHODS: Salvage of abandoned vascular access sites was attempted in 16 patients with hemodialysis catheters. These vascular access sites were salvaged using endovascular bypass techniques to redirect the access flow to a nonarterialized vein as a new outflow conduit or cannulation segment...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29552930/cardiac-implantable-electronic-device-and-vascular-access-strategies-to-overcome-problems
#19
Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29546789/safety-and-efficacy-of-the-angiojet-device-in-the-treatment-of-thrombosed-arteriovenous-fistula-and-grafts-a-systematic-review
#20
Philip Gc Chan, Gerard S Goh
PURPOSE: The AngioJet Hemolytic Thrombectomy Device "AngioJet" (Boston Scientific, Malborough, MA, USA) is a rheolytic thrombectomy device that can be used in the treatment of hemodialysis arteriovenous fistula and graft thrombosis. We aim to appraise the current evidence on AngioJet thrombectomy in hemodialysis vascular access thrombosis, and to determine its safety, including complications and efficacy. MATERIALS AND METHODS: An electronic literature search was performed on the MEDLINE and Embase databases...
March 1, 2018: Journal of Vascular Access
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