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https://www.readbyqxmd.com/read/29792174/perspectives-on-clinical-use-of-bioimpedance-in-hemodialysis-focus-group-interviews-with-renal-care-professionals
#1
Jenny Stenberg, Catrin Henriksson, Magnus Lindberg, Hans Furuland
BACKGROUND: Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals' perceived barriers and facilitators for use of bioimpedance in clinical practice. METHODS: Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device...
May 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29784614/tradeoffs-in-vascular-access-selection-in-elderly-patients-initiating-hemodialysis-with-a-catheter
#2
Timmy Lee, Joyce Qian, Mae Thamer, Michael Allon
RATIONALE & OBJECTIVE: National vascular access guidelines recommend placement of arteriovenous fistulas (AVFs) over grafts (AVGs) in hemodialysis patients, but have not been comprehensively assessed in the elderly. We evaluated clinically relevant vascular access outcomes in elderly patients receiving an AVF or AVG after hemodialysis therapy initiation. STUDY DESIGN: Retrospective cohort study using national administrative data. SETTINGS & PARTCIPANTS: Claims data from the US Renal Data System of 9,458 US patients 67 years and older who initiated hemodialysis therapy from July 1, 2010, to June 30, 2011, with a catheter and received an AVF (n=7,433) or AVG (n=2,025) within the ensuing 6 months...
May 18, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29781153/value-of-duplex-doppler-ultrasonography-for-the-evaluation-of-dysfunctional-hemodialysis-access-arteriovenous-fistulas-prior-to-endovascular-interventions
#3
Isik Conkbayir, Pinar Celtikci, Onur Ergun, Hasan Ali Durmaz
PURPOSE: To demonstrate accuracy of duplex Doppler ultrasonography (DUS) for the evaluation of native-vein arteriovenous fistula (AVF) dysfunction in end-stage renal disease patients. METHODS: This retrospective study included 60 patients with dysfunctioning native-vein AVF evaluated with DUS and digital subtraction angiography (DSA) whose results were compared for detection, identification, and localization of AVF lesions. We calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DUS and evaluated the agreement between DUS and DSA by the Cohen's kappa coefficient (κ)...
May 21, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29777015/a-patient-with-hemodialysis-access-problems
#4
Vandana Dua Niyyar, Charmaine E Lok
No abstract text is available yet for this article.
May 18, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29772982/randomized-pilot-study-to-compare-metal-needles-versus-plastic-cannulae-in-the-development-of-complications-in-hemodialysis-access
#5
Rosa M Marticorena, Niki Dacouris, Sandra M Donnelly
BACKGROUND: Hemodialysis requires needle insertions every treatment. Needle injury (mechanical or hemodynamic) may cause complications (aneurysms/stenosis) that compromise dialysis delivery requiring interventions. Metal needles have a sharp slanted "V"-shaped cutting tip; plastic cannulae have a dull round tip and four side holes. Preliminary observations demonstrated a difference in intradialytic blood flow images and mean Doppler velocities at cannulation sites between the two devices...
May 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29750827/self-cannulation-of-the-vascular-access-in-home-hemodialysis-overcoming-patient-level-barriers
#6
Frank L Ward, Rose Faratro, Rory F McQuillan
Patients with end-stage kidney disease who are considering home hemodialysis (HHD) face the challenge of learning to self-cannulate their arteriovenous access. Current practice discourages the use of tunneled central venous catheters, with recent indications that self-cannulating patients have superior outcomes. Patient-level barriers do not appear to preclude a successful HHD program and should not be viewed as insurmountable by healthcare staff or patients. The healthcare team must address patient fears while instructing the patient to perform self-cannulation safely...
May 11, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29742952/a-pilot-study-to-measure-vascular-compliance-changes-during-fistula-maturation-using-open-source-software
#7
Barry Belmont, Dae Woo Park, Albert Shih, Matthew Leavitt, Brett Plattner, Peter K Henke, William F Weitzel
PURPOSE: Autogenous arteriovenous fistulas are the preferred access for hemodialysis. Yet when created, fistulas often fail to mature, requiring surgical or radiologic interventions before their use. This pilot study measures the vascular wall elasticity and flow gradient using an open-source ultrasound software program designed to aid in assessing fistula maturation. METHODS: A total of seven end-stage renal disease patients were enrolled for our study after providing informed consent...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29739749/prevalence-of-central-vein-stenosis-in-patients-referred-for-vein-mapping
#8
Fasika M Tedla, Guerrier Clerger, Dale Distant, Moro Salifu
BACKGROUND AND OBJECTIVES: Central vein stenosis is considered to be common in patients on hemodialysis but its exact prevalence is not known. In this study, we report the prevalence of central vein stenosis in patients with CKD referred for vein mapping. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective study of adult patients who had bilateral upper extremity venographic vein mapping from September 1, 2011 to December 31, 2015. Patients with and without stenosis were compared for differences in clinical or demographic characteristics...
May 8, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29730781/role-of-antiplatelet-therapy-in-the-durability-of-hemodialysis-access
#9
Satinderjit Locham, Robert J Beaulieu, Hanaa Dakour-Aridi, Besma Nejim, Mahmoud B Malas
BACKGROUND: Antiplatelet therapy (APT) is often used on anecdotal grounds to improve vascular access patency. The aim of this study was to assess the role of APT in hemodialysis (HD) patients undergoing arteriovenous fistula (AVF) or graft (AVG) placement. METHODS: All patients in a large HD vascular qualitative initiative database (2011-2017) were included and divided into no antiplatelet therapy (no-APT) vs. any APT [aspirin (ASA) or P2Y12 inhibitors (PI)]. Multivariate [logistic (MLR) and Cox (MCR) regression] analyses were used as appropriate...
May 5, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29724177/effectiveness-of-informational-decision-aids-and-a-live-donor-financial-assistance-program-on-pursuit-of-live-kidney-transplants-in-african-american-hemodialysis-patients
#10
L Ebony Boulware, Patti L Ephraim, Jessica Ameling, LaPricia Lewis-Boyer, Hamid Rabb, Raquel C Greer, Deidra C Crews, Bernard G Jaar, Priscilla Auguste, Tanjala S Purnell, Julio A Lamprea-Monteleagre, Tope Olufade, Luis Gimenez, Courtney Cook, Tiffany Campbell, Ashley Woodall, Hema Ramamurthi, Cleomontina A Davenport, Kingshuk Roy Choudhury, Matthew R Weir, Donna S Hanes, Nae-Yuh Wang, Helene Vilme, Neil R Powe
BACKGROUND: African Americans have persistently poor access to living donor kidney transplants (LDKT). We conducted a small randomized trial to provide preliminary evidence of the effect of informational decision support and donor financial assistance interventions on African American hemodialysis patients' pursuit of LDKT. METHODS: Study participants were randomly assigned to receive (1) Usual Care; (2) the Providing Resources to Enhance African American Patients' Readiness to Make Decisions about Kidney Disease (PREPARED); or (3) PREPARED plus a living kidney donor financial assistance program...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29724122/a-meta-analysis-of-the-association-between-diabetic-patients-and-avf-failure-in-dialysis
#11
Yan Yan, Dan Ye, Liu Yang, Wen Ye, Dandan Zhan, Li Zhang, Jun Xiao, Yan Zeng, Qinkai Chen
PURPOSE: The most preferable vascular access for patients with end-stage renal failure needing hemodialysis is native arteriovenous fistula (AVF) on account of its access longevity, patient morbidity, hospitalization costs, lower risks of infection and fewer incidence of thrombotic complications. Meanwhile, according to National Kidney Foundation (NKF)̸Dialysis Out-comes Quality Initiative (DOQI) guidelines, AVF is more used than before. However, a significant percentage of AVF fails to support dialysis therapy due to lack of adequate maturity...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29706252/gadolinium-based-contrast-agents-in-kidney-disease-comprehensive-review-and-clinical-practice-guideline-issued-by-the-canadian-association-of-radiologists
#12
REVIEW
Nicola Schieda, Jason I Blaichman, Andreu F Costa, Rafael Glikstein, Casey Hurrell, Matthew James, Pejman Jabehdar Maralani, Wael Shabana, An Tang, Anne Tsampalieros, Christian van der Pol, Swapnil Hiremath
Use of gadolinium-based contrast agents (GBCAs) in renal impairment is controversial, with physician and patient apprehension in acute kidney injury (AKI), chronic kidney disease (CKD), and dialysis because of concerns regarding nephrogenic systemic fibrosis (NSF). The position that GBCAs are absolutely contraindicated in AKI, CKD stage 4 or 5 (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m2 ) and dialysis-dependent patients is outdated, and may limit access to clinically necessary contrast-enhanced MRI examinations...
May 2018: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/29703700/improved-patency-of-eptfe-grafts-as-a-hemodialysis-access-site-by-seeding-autologous-endothelial-cells-expressing-fibulin-5-and-vegf
#13
Itai Tzchori, Mizied Falah, Denis Shteynberg, Dana Levin Ashkenazi, Zeev Loberman, Luba Perry, Moshe Y Flugelman
Small caliber synthetic vascular grafts used for dialysis access sites have high failure rates due to neointima formation and thrombosis. Seeding synthetic grafts with endothelial cells (ECs) provides a biocompatible surface that may prevent graft failure. We tested the use of ePTFE grafts seeded with autologous ECs expressing fibulin-5 and vascular endothelial growth factor (VEGF), as a dialysis access site in a porcine model. We connected the carotid arteries and jugular veins of 12 miniature pigs using 7-mm ePTFE grafts; five grafts were seeded with autologous venous ECs modified to express fibulin-5 and VEGF, and seven unseeded grafts were implanted at the same location and served as controls...
April 5, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/29703177/functional-status-pre-dialysis-health-and-clinical-outcomes-among-elderly-dialysis-patients
#14
Silvi Shah, Anthony C Leonard, Charuhas V Thakar
BACKGROUND: Elderly patients comprise the fastest growing population initiating dialysis in United States. The impact of poor functional status and pre-dialysis health status on clinical outcomes in elderly dialysis patients is not well studied. METHODS: We studied a retrospective cohort of 49,645 incident end stage renal disease patients that initiated dialysis between January 1, 2008 and December 31, 2008 from the United States Renal Data System with linked Medicare data covering at least 2 years prior to dialysis initiation...
April 27, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29701411/true-brachial-artery-aneurysm-after-arteriovenous-fistula-for-hemodialysis-case-report
#15
Tiago Soares, Ricardo Castro-Ferreira, João Rocha Neves, Marina Neto, Joel Sousa, José Pedro Pinto, Luis Gamas, Alfredo Cerqueira, Sérgio Sampaio, José Fernando Teixeira
INTRODUCTION: Brachial artery aneurysms are relatively uncommon and generally due to infectious, post-traumatic or iatrogenic etiology. They seem to affect 4.5% of arteriovenous fistula. The usual manifestation is an accidental finding of a pulsatile, painless, and asymptomatic mass. Complications include sac thrombosis, thromboembolic ischaemic events, and disruption with profuse bleeding. METHODS: The aim of this study is to present a case of true brachial artery aneurysm in end-stage renal disease patient after arteriovenous fistula creation...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701407/creative-vascular-access-construction-in-same-patient
#16
Pedro Pinto Sousa, Paulo Almeida, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Creating and maintaining a functional vascular access(VA) is a critical factor in the survival of a dialysis patient. However, it will not function forever, implying a creative attitude from the vascular surgeon either to maintain its functionality or built a new one wherever possible, being it autologous or synthetic. METHODS: Describe the VA history of a 59years-old male with morbid obesity and end-stage chronic kidney disease. RESULTS: His VA construction started in2012 with failed attempts in both forearms until a functional brachiocephalic artery-venous fistula(AVF) in the right upper limb was achieved, but was deemed to ligation as severe venous hypertension secondary to central venous disease related to CVC use...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697182/leadless-pacemaker-placement-in-a-patient-with-chronic-kidney-disease-a-strategy-to-preserve-central-veins
#17
Joan Alberto Maradey, Geoffrey Te Jao, Tushar J Vachharajani
Cardiac rhythm disorder is frequently encountered in hemodialysis patients and is often treated with a cardiovascular implantable electronic device (CIED). The conventional CIED requires placement of transvenous leads resulting in subclinical central venous stenosis, which can adversely affect the successful creation of a permanent dialysis vascular access. The technological advancement of a leadless pacemaker provides an opportunity to implement a strategy to preserve central veins in patients with chronic kidney disease...
April 26, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29690817/failure-to-place-a-tunneled-hemodialysis-catheter-due-to-malformation-of-right-internal-jugular-vein-draining-to-subclavian-vein
#18
Li-Na Zhu, Li-Jun Mou, Ying-Hu, Gui-Na Wei, Jun-Feng Sun
The right internal jugular vein (IJV) is an important access site for hemodialysis catheterization. Venous cannulation failure is usually caused by central venous stenosis and is rarely related to vessel malformation. We herein present a case of failure to place a tunneled hemodialysis catheter into the right IJV. The patient had an arteriovenous fistula in the right arm with inadequate flow and a history of multiple central venous catheterizations. The guidewire was repeatedly misplaced into the right subclavian vein (SV) regardless of the technique used...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29680929/evaluation-of-factors-affecting-time-to-achieve-dry-weight-among-hemodialysis-patients-using-bioimpedance-spectroscopy
#19
Amjad Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Nafees Ahmad, Siew Hua Gan
BACKGROUND: Achieving and maintaining dry weight appears to be an effective strategy for controlling and maintaining normotension among hypertensive patients on hemodialysis (HD). OBJECTIVE: The present study aimed to determine the time at which the majority of patients achieve postdialysis dry weight using bioimpedance spectroscopy (BIS). METHODS: A total of 220 HD patients were prospectively assessed for fluid overload using the Fresenius body composition monitor (BCM)...
April 22, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29678651/post-general-anesthesia-ultrasound-guided-venous-mapping-increases-autogenous-access-placement-rates
#20
C Y Maximilian Png, Adam Korayem, David J Finlay
OBJECTIVE: This study investigates the impact of introducing a post-general anesthesia ultrasound mapping (PAUS) on the type of vascular access chosen for hemodialysis in patients without previous accesses. METHODS: 203 of 297 consecutive patients met inclusion criteria and were reviewed. Within-subjects analysis was performed on patients with both an outpatient ultrasound-guided vein mapping and a PAUS using sign tests and Wilcoxon signed ranked tests. Further, a between-subjects analysis added patients with only the outpatient vein mapping; demographic and comorbidity data were analyzed using t-tests and chi-squared tests...
April 17, 2018: Annals of Vascular Surgery
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