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https://www.readbyqxmd.com/read/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#1
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28105639/persistent-variation-in-medicare-payment-authorization-for-home-hemodialysis-treatments
#2
Adam S Wilk, Richard A Hirth, Wei Zhang, John R C Wheeler, Marc N Turenne, Tammie A Nahra, Kathryn K Sleeman, Joseph M Messana
OBJECTIVE: To analyze variation in medical care use attributable to Medicare's decentralized claims adjudication process as exemplified in home hemodialysis (HHD) therapy. DATA SOURCES/STUDY SETTING: Secondary data analysis using 2009-2012 paid Medicare claims for HHD and in-center hemodialysis (IHD). STUDY DESIGN: We compared variation across Medicare administrative contractors (MACs) in predicted paid treatments per standardized patient-month for HHD and IHD patients...
January 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#3
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28095482/an-increase-in-mean-platelet-volume-platelet-count-ratio-is-associated-with-vascular-access-failure-in-hemodialysis-patients
#4
Dong Ho Shin, So Yon Rhee, Hee Jung Jeon, Ji-Young Park, Shin-Wook Kang, Jieun Oh
After stenosis of arteriovenous vascular access in hemodialysis patients, platelets play a crucial role in subsequent thrombus formation, leading to access failure. In a previous study, the mean platelet volume (MPV)/platelet count ratio, but not MPV alone, was shown to be an independent predictor of 4-year mortality after myocardial infarction. However, little is known about the potential influence of MPV/platelet count ratio on vascular access patency in hemodialysis patients. A total of 143 patients undergoing routine hemodialysis were recruited between January 2013 and February 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28074626/radio-cephalic-fistula-recovered-with-drainage-to-forearm-basilic-vein
#5
António Norton de Matos, Clemente Neves Sousa, Paulo Almeida, Paulo Teles, Luís Loureiro, Gabriela Teixeira, Duarte Rego, Sérgio Teixeira
Dysfunction problems with vascular access are a concern to patients and dialysis units. The vascular surgeon should analyse such dysfunction and perform a careful assessment of the vascular network in order to find new fistula layouts. We introduce and discuss the case of creation of a radio-cephalic fistula with outflow into the forearm basilic vein through rotation of the forearm basilic vein toward the cephalic vein in the forearm of an 88-year-old hemodialysis male patient. This technique enables extending fistula patency and improves cost efficiency...
January 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#6
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28064472/arteriovenous-grafts-much-maligned-but-in-need-of-reconsideration
#7
Michael Allon
There are substantial variations in arteriovenous fistula (AVF) use among hemodialysis patients in different countries, in different regions of the U.S., and even in different hemodialysis units within a single metropolitan area. These variations persist after adjustment for patient demographics and comorbidities, suggesting that practice patterns play a major role in determining the frequency of AVF use. These observations led to vascular access guidelines urging nephrologists and surgeons to increase AVF creation in patients with chronic kidney disease...
January 8, 2017: Seminars in Dialysis
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
#8
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...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28051278/assessment-of-apoptosis-in-the-native-vein-used-for-hemodialysis-access
#9
Laura Leci-Tahiri, Božo Krušlin, Majda Vučić, Zdenko Sonicki, Ivo Lovričević
AIM: To determine whether apoptosis is more common in previously punctured native veins than in non-punctured native veins among patients who undergo surgical creation of arteriovenous fistula (AVF) for dialysis access. METHODS: Cephalic vein specimens were obtained from January 1, 2013 to December 31, 2014 from 60 patients, 30 with previously punctured native veins and 30 with non-punctured native veins. Before AVF placement, a 1-cm vein segment was excised from distal part of the vein for histological, histochemical, and immunohistochemical analysis...
December 31, 2016: Croatian Medical Journal
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#10
Luciene P Magalhães, Luciene M Dos Reis, Fabiana G Graciolli, Benedito J Pereira, Rodrigo B de Oliveira, Altay A L de Souza, Rosa M Moyses, Rosilene M Elias, Vanda Jorgetti
BACKGROUND: Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality...
2017: PloS One
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
#11
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/28042558/long-term-outcomes-of-arteriovenous-grafts-for-hemodialysis-in-lower-extremities
#12
Seok Han, Dan Song, Sangchul Yun
PURPOSE: The lower extremity has received its fair share of attention as a vascular access site in patients who have exhausted their upper arm vessels. However, experiences with lower extremity arteriovenous grafts (AVGs) have so far been disappointing because of high infection rates and severe limb ischemia. We report our experience with hemodialysis access from the lower extremity. MATERIALS AND METHODS: A retrospective review of 60 lower extremity AVGs created between January 2003 and December 2011 was performed...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/28041805/basilic-elevation-transposition-may-improve-the-clinical-outcomes-for-superficialization-of-basilic-arteriovenous-fistula-veins
#13
Shouwen Wang, Michele S Wang, William C Jennings
OBJECTIVE: Basilic vein arteriovenous fistulas are an important and common option for hemodialysis access and require superficialization before use. Various superficialization techniques have been employed, such as basilic tunnel transposition (BTT), basilic elevation, and basilic elevation transposition (BET). Each technique may have advantages and disadvantages, and there have been few reports directly comparing the outcomes of these techniques. This report compares the clinical outcomes of BET vs BTT performed by a single operator and discusses some technical considerations derived from this study and the literature...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28031406/complications-of-the-arteriovenous-fistula-a-systematic-review
#14
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...
December 28, 2016: 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
#15
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...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28027805/variations-in-outcomes-of-hemodialysis-vascular-access-by-race-ethnicity-in-the-elderly
#16
Karen Woo, Laura Gascue, Dana P Goldman, John A Romley
OBJECTIVE: Prevalence of end-stage renal disease, modality of treatment, and type of hemodialysis vascular access used varies widely by race/ethnicity in the United States, but outcomes of hemodialysis vascular access by race/ethnicity are poorly described. The objective of this study is to evaluate variations in outcomes of hemodialysis vascular access in the elderly by race/ethnicity. METHODS: Medicare outpatient, inpatient, and carrier files were queried from 2006 to 2011 for beneficiaries that were age ≥66 years and dialysis-dependent at time of index fistula/graft creation, qualified for Medicare by age only, and were continuously enrolled in Medicare 12 months before and after index fistula/graft creation...
December 24, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28025835/bedside-tunneled-dialysis-catheter-removal-a-lesson-learned-from-nephrology-trainees
#17
REVIEW
Tibor Fülöp, Mihály B Tapolyai, Mohit Agarwal, Arnaldo Lopez-Ruiz, Miklos Z Molnar, Neville R Dossabhoy
Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/28001173/patient-in-chronic-hemodialysis-with-right-atrial-mass-thrombus-fungal-endocarditis-or-atrial-myxoma
#18
Talita G Salani, Cynthia de Moura Borges, Carolina S Urbini, Patrícia Schincariol, Kélcia Rosana da Silva Quadros, Maria Almerinda Ribeiro-Alves, Rodrigo Bueno de Oliveira
We present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD) by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA). The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI) indicated for the diagnosis of myxoma in RA...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27994864/diabetic-kidney-disease-patients-on-hemodialysis-a-retrospective-survival-analysis-across-different-socioeconomic-groups
#19
Madhusudan Vijayan, Saranya Radhakrishnan, Georgi Abraham, Milly Mathew, Krishnaswamy Sampathkumar, Nevin Philip Mancha
BACKGROUND: Diabetic kidney disease is the leading cause of stage 5 chronic kidney disease (CKD) in India. Renal replacement therapy (RRT) is accessible to very few patients because of socioeconomic deprivation. We studied the effect of diabetes and socioeconomic status on the outcome of patients on maintenance hemodialysis (MHD). METHODS: We retrospectively analyzed the outcome of 897 patients (629 males/268 females; mean age ± standard deviation 48.69 ± 14.27 years) initiated on MHD from 2003 to 2009 at five dialysis centers in south India...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27993572/chills-during-hemodialysis-prediction-and-prevalence-of-bacterial-infections-a-retrospective-cohort-study
#20
D Shepshelovich, D Yelin, Bach L Or, N Halevy, Y Ziv, H Green, B Rozen-Zvi, H Ben-Zvi, J Bishara, A Gafter-Gvili, D Yahav
INTRODUCTION: Chills are a complication of patients undergoing hemodialysis. The rate of infection among hemodialysis patients presenting with chills is not well established and empirical broad spectrum antibiotics are usually the rule. METHODS: We performed a retrospective study aiming to assess the rates of infection and bacteremia in hemodialysis patients presenting with chills. We evaluated risk factors for infection and bacteremia and tested a prediction model for infection...
December 16, 2016: American Journal of Medicine
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