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https://www.readbyqxmd.com/read/28742531/variable-volume-kinetic-model-to-estimate-absolute-blood-volume-in-patients-on-dialysis-using-dialysate-dilution
#1
Hamed Samandari, Daniel Schneditz, Michael J Germain, Joseph Horowitz, Christopher V Hollot, Yossi Chait
Long- and short-term adverse outcomes in hemodialysis (HD) have been associated with intradialytic hypotension, a common HD complication and significant cause of morbidity. It has been suggested that knowledge of absolute blood volume (ABV) could be used to significantly improve treatment outcomes. Different dilution-based protocols have been proposed for estimating ABV, all relying on the classic mono-exponential back-extrapolation algorithm (BEXP). In this paper, we introduce a dialysate dilution protocol and an estimation algorithm based on a variable-volume, two-compartment, intravascular blood water content kinetic model (VVKM)...
July 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28739575/fda-regulatory-perspectives-for-studies-on-hemodialysis-vascular-access
#2
Frank P Hurst, Robert E Lee, Aliza M Thompson, Brian D Pullin, Douglas M Silverstein
In an effort to foster innovation and new product development, the American Society of Nephrology and the US Food and Drug Administration partnered to form the Kidney Health Initiative in 2012. Part of the Kidney Health Initiative's mission is to foster development of therapies by creating a collaborative environment where the US Food and Drug Administration and the greater nephrology community can interact to optimize product evaluation. This particular Kidney Health Initiative project focused on products related to hemodialysis vascular access, with the goal of clarifying appropriate trial end points that could subsequently inform clinical, regulatory, and coverage decisions...
July 24, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#3
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28725317/prevalence-of-metabolic-syndrome-among-the-end-stage-renal-disease-patients-on-hemodialysis
#4
Khaled A Alswat, Awwadh Althobaiti, Khulod Alsaadi, Amaal Saeed Alkhaldi, Maryam Mutlaq Alharthi, Walaa Abduraheem Abuharba, Ahmed A Alzaidi
BACKGROUND: Patients with metabolic syndrome (MetS) have a 2.6-fold greater risk of incident chronic kidney disease (CKD). The primary goal of this study was to assess the prevalence of MetS in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) and the impact of MetS presence on HD-related outcomes. METHODS: This is a cross-sectional study conducted in the Dialysis Center, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia. It was conducted among ESRD patients that attended the Dialysis Center between August 2013 and September 2016...
August 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#5
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28710090/the-clinical-and-economic-effect-of-vascular-access-selection-in-patients-initiating-hemodialysis-with-a-catheter
#6
Alian Al-Balas, Timmy Lee, Carlton J Young, Jeffrey A Kepes, Jill Barker-Finkel, Michael Allon
Patients in the United States frequently initiate hemodialysis with a central venous catheter (CVC) and subsequently undergo placement of a new arteriovenous fistula (AVF) or arteriovenous graft (AVG). Little is known about the clinical and economic effects of initial vascular access choice. We identified 479 patients starting hemodialysis with a CVC at a large medical center (during 2004-2012) who subsequently had an AVF (n=295) or AVG (n=105) placed or no arteriovenous access (CVC group, n=71). Compared with patients receiving an AVG, those receiving an AVF had more frequent surgical access procedures per year (1...
July 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28706886/the-effects-of-indoxyl-sulfate-induced-endothelial-microparticles-on-neointimal-hyperplasia-formation-in-an-ex-vivo-model
#7
Jung-Hwa Ryu, HeeJung Park, Seung-Jung Kim
PURPOSE: Neointimal hyperplasia (NH) is considered to be one of the main causes of vascular access occlusion in patients receiving hemodialysis. Endothelial injury and TGF-β-mediated proliferation of vascular smooth muscle cells (VSMCs) induce NH. Endothelial microparticles (EMPs) are also increased by endothelial injury. We aimed to investigate the effects of EMPs and TGF-β expression on VSMC proliferation and their contributions to NH formation in an ex vivo model. METHODS: EMPs were collected from the culture media of human umbilical vein endothelial cells treated with indoxyl sulfate (IS, 250 µg/mL) after ultracentrifugation at 100,000 × g...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28705077/fifty-years-of-hemodialysis-access-literature-the-fifty-most-cited-publications-in-the-medical-literature
#8
Edvard Skripochnik, David J O'Connor, Eric B Trestman, Evan C Lipsitz, Larry A Scher
Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28700182/-brachial-artery-pseudoaneurysm-a-rare-but-serious-complication-in-hemodialysis-patients-with-arteriovenous-fistula
#9
Andrea Mancini, Giuseppe Castriotta, Pernina Angelini, Michele Bozzi, Vincenzo Giancaspro, Elvira La Raia, Maria Teresa Nisi, Anna Rita Proscia, Giuseppe Tarantino, Ottavia Vitale, Cristoforo Cuzzola
A pseudoaneurysm or false aneurysm of the brachial artery is an uncommon occurrence in patients receiving hemodialysis with arteriovenous fistula (AVF). We describe the case of a 76-year-old woman presenting with a large, tender, pulsatile mass in the right antecubital region 10 cm from the AVF. B-mode ultrasound examination revealed a saccular hematoma. Color doppler showed a recirculation movement of blood, creating a two colors image called "Korean flag". The patient was transferred to the surgical unit where she first underwent ultrasound-guided compression and then surgical repair of the pseudoaneurysm...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28700180/-superior-cava-vein-stenosis-in-a-hemodialysis-patient-with-long-term-central-venous-catheter-and-vascular-graft-a-case-report
#10
Carlo Jovane, Piera Farfaglia, Anna Maria Ierardi, Laura Rimoldi, Elisabetta Sogni, Carmela Figliola, Daniela Pogliani, Matteo Tozzi, Elena Caramella, Pasquale Esposito, Alessandro Castiglioni
Recently, the use of central venous catheters (CVC) as a vascular access in patients undergoing hemodialysis is significantly increased, mainly because of the aging of this population and the presence of several comorbidities. However, the implantation and the long stay of CVC are associated with many complications. Among them, central venous stenosis represents one of the most common problems that, if not properly diagnosed, could lead to vascular thrombosis and consequent vascular access malfunction. Here, we report a case of a 38-year-old patient, who underwent hemodialysis firstly by a CVC long-term into right jugular vein and then by a prosthetic fistula in the ipsilateral limb...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#11
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28686684/correction-heart-rate-variability-during-hemodialysis-is-an-indicator-for-long-term-vascular-access-survival-in-uremic-patients
#12
Ya-Ting Huang, Yu-Ming Chang, I-Ling Chen, Chuan-Lan Yang, Show-Chin Leu, Hung-Li Su, Jsun-Liang Kao, Shih-Ching Tsai, Rong-Na Jhen, Woung-Ru Tang, Chih-Chung Shiao
[This corrects the article DOI: 10.1371/journal.pone.0172212.].
2017: PloS One
https://www.readbyqxmd.com/read/28685192/venous-thrombosis-and-stenosis-after-peripherally-inserted-central-catheter-placement-in-children
#13
H Stella Shin, Alexander J Towbin, Bin Zhang, Neil D Johnson, Stuart L Goldstein
BACKGROUND: Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children...
July 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28684919/point-prevalence-of-complications-between-the-y-connection-technique-and-the-usual-care-technique-for-blood-restitution-in-patients-of-an-outpatient-hemodialysis-unit-a-comparison
#14
Nadine Tacchini-Jacquier, Henk Verloo
BACKGROUND: Central venous catheter-related infections (CVCIs) in patients on maintenance hemodialysis (HD) have been documented due to unsafe/unsterile manipulations by nurses during HD machine deconnection and reconnection. Given the gravity of CVCIs in HD patients using catheter access, precise, safe installation of the device, and good nursing technique are crucial. AIM: To assess and compare safety performance and complications of a Y-connection (n=133) versus the usual tunneled central venous catheter (CVC) technique (n=73) among HD patients and then explore preferences between techniques among patients and frontline HD nurses...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28681510/impact-of-drugs-on-intradialytic-hypotension-antihypertensives-and-vasoconstrictors
#15
Tara I Chang
Intradialytic hypotension (IDH) is a common complication of hemodialysis and is associated with numerous adverse outcomes including cardiovascular events, inadequate dialysis, loss of vascular access, and death. It is estimated that approximately 20%-30% of all dialysis sessions are affected by IDH. In seeking ways to reduce the occurrence of IDH, dialysis providers often turn to pharmacological approaches: withholding antihypertensive medications prior to hemodialysis or administering vasoconstrictor medications...
July 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28679363/incremental-short-daily-home-hemodialysis-a-case-series
#16
Stephanie M Toth-Manikowski, Surekha Mullangi, Seungyoung Hwang, Tariq Shafi
BACKGROUND: Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. CASE PRESENTATION: From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen...
July 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28668967/anatomy-revisited-hemodialysis-catheter-malposition-in-the-left-ascending-lumbar-vein
#17
Stefan Büttner, Sammy Patyna, Sarah Rudolf, Despina Avaniadi, Moritz Kaup, Helmut Geiger, Christoph Betz
In selected cases, cuffed tunneled catheters via the iliac vein are implanted as a last resort access for hemodialysis. To monitor the correct position, sonography of the inferior vena cava (IVC) is sufficient in most cases. Position control using an X-ray of the abdomen is not routinely recommended when femoral catheters are implanted. In this report, we describe the case of a 59-year-old patient on chronic hemodialysis due to granulomatosis with polyangiitis and complex shunt history with multiple shunt occlusions and revisions...
July 1, 2017: Blood Purification
https://www.readbyqxmd.com/read/28666501/spontaneous-rupture-and-dissection-of-aspergillus-infected-arteriovenous-fistula
#18
Syed Nayer Mahmud, Behzad Kaleem Baloch, Muhammed Safdar, Muhammed Saeed
Patients with end stage renal disease need a vascular access like arteriovenous (AV) fistula, AV graft or central venous catheter for hemodialysis. However, AV fistula can be complicated due to infection, stenosis, ulceration etc. Among these, spontaneous rupture of AV fistula is rare and can be due to stenosis or infection. Fungal infection of AV fistula is very rare and the most common organism involved is Candida. Infection of native AV fistula with Aspergillusis not reported in the literature. This case discusses the spontaneous rupture and dissection of an Aspergillusinfected arteriovenous fistula, requiring urgent closure and repairing of vessel...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28665461/clinical-predictors-of-recurrent-stenosis-and-need-for-re-intervention-in-the-cephalic-arch-in-patients-with-brachiocephalic-av-fistulas
#19
Saravanan Balamuthusamy, Alagarsamy Lakku Reddi, Machaiah H Madhrira, Balamurugan Sankarapandian, Peter Nguyen, Avinash Vallurupalli, William Gabbard, Nishant Jalandhara, Albert Yurvati
INTRODUCTION: Cephalic arch stenosis is one of the most common reasons for repeated endovascular intervention and eventual abandonment of access in hemodialysis patients. There is no prediction model to identify risk factors for recurrent cephalic arch stenosis. We have developed a mathematical model to predict the need for reintervention in brachiocephalic (BC) fistulas with recurrent cephalic arch stenosis. METHODS: Single-center retrospective analysis of 143 patients with a BC fistula referred to the vascular clinic for access dysfunction who underwent cephalic arch angioplasty were included for the analysis...
June 23, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28664239/blood-flow-in-idealized-vascular-access-for-hemodialysis-a-review-of-computational-studies
#20
Bogdan Ene-Iordache, Andrea Remuzzi
Although our understanding of the failure mechanism of vascular access for hemodialysis has increased substantially, this knowledge has not translated into successful therapies. Despite advances in technology, it is recognized that vascular access is difficult to maintain, due to complications such as intimal hyperplasia. Computational studies have been used to estimate hemodynamic changes induced by vascular access creation. Due to the heterogeneity of patient-specific geometries, and difficulties with obtaining reliable models of access vessels, idealized models were often employed...
June 29, 2017: Cardiovascular Engineering and Technology
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