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https://www.readbyqxmd.com/read/28912248/multi-disciplinary-vascular-access-care-and-access-outcomes-in-people-starting-hemodialysis-therapy
#1
Simardeep Gill, Robert Quinn, Matthew Oliver, Fareed Kamar, Rameez Kabani, Daniel Devoe, Priyanka Mysore, Neesh Pannu, Jennifer MacRae, Braden Manns, Brenda Hemmelgarn, Matthew James, Marcello Tonelli, Adriane Lewin, Ping Liu, Pietro Ravani
BACKGROUND AND OBJECTIVES: Fistulas, the preferred form of hemodialysis access, are difficult to establish and maintain. We examined the effect of a multidisciplinary vascular access team, including nurses, surgeons, and radiologists, on the probability of using a fistula catheter-free, and rates of access-related procedures in incident patients receiving hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined vascular access outcomes in the first year of hemodialysis treatment before (2004-2005, preteam period) and after the implementation of an access team (2006-2008, early-team period; 2009-2011, late-team period) in the Calgary Health Region, Canada...
September 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28912005/proximal-radial-artery-arteriovenous-fistula-for-hemodialysis-vascular-access
#2
William C Jennings, Alexandros Mallios, Nasir Mushtaq
OBJECTIVE: This study reviewed our experience with proximal radial artery-based arteriovenous fistulas (PRA-AVFs) for hemodialysis vascular access, evaluating characteristics of the patients, functional patency, risk of steal syndrome, survival of the patient, and technical considerations. METHODS: We retrospectively analyzed our database of consecutive patients, identifying those individuals with a PRA-AVF created during a 12-year period. In addition to physical examination, all patients underwent ultrasound vessel mapping by the operating surgeon, identifying the PRA-AVF configuration and outflow target most likely to succeed...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28910799/effects-of-hemodialysis-therapy-using-dialyzers-with-medium-cut-off-membranes-on-middle-molecules
#3
Alexander H Kirsch, Alexander R Rosenkranz, Raphael Lyko, Detlef H Krieter
The removal of larger middle molecules, such as free immunoglobulin light chains (FLC), is poor with most currently used dialysis technologies. While hemodiafiltration (HDF) provides enhanced clearance of middle molecules compared to high-flux hemodialysis (HD), this technique is currently not approved in some regions and, hence, not accessible for all patients. The retention of middle molecules is thought to be one factor, which contributes to excessive morbidity and mortality in HD patients. The development of medium cut-off (MCO) dialysis membranes is aimed at a more efficient clearance of larger uremic toxins while retaining albumin and may extend the benefit of enhanced solute removal to more patients...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28904934/comparison-of-complications-of-arteriovenous-fistula-with-permanent-catheter-in-hemodialysis-patients-a-six-month-follow-up
#4
Ali Momeni, Saeed Mardani, Maryam Kabiri, Masoud Amiri
BACKGROUND: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis procedure. Due to insufficient reliable information on the comparison between AVF and PC, this study was conducted to compare AVF and PC regarding dialysis adequacy. MATERIALS AND METHODS: This prospective study was carried out from March, 2013 to September, 2013. In this study, 76 hemodialysis patients were enrolled and assigned to two unequal groups of AVF and PC...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28899228/intraoperative-venoplasty-to-facilitate-placement-of-tunneled-catheters-for-hemodialysis
#5
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective With the implementation of the K-DOQI guidelines, more patients are in need of long-term dialysis catheters until maturation of the arteriovenous fistula. However, on occasion, when placing a tunneled cuffed catheter for hemodialysis, we have encountered difficulty with passing the guidewire in spite of demonstration of a patent cervical portion of the internal jugular vein on duplex. Herein, we review our experience with intraoperative venoplasty for placement of Tesio™ catheters (Medcomp Harleysville, PA)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28898900/the-complications-of-vascular-access-in-hemodialysis
#6
Avais Masud, Eric J Costanzo, Roman Zuckerman, Arif Asif
No abstract text is available yet for this article.
September 12, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#7
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28887265/modified-staple-aneurysmorrhaphy-for-treating-arteriovenous-fistula-related-venous-aneurysms
#8
R Moskowitz, E Fakhoury, K James
Autogenous arteriovenous fistulas (AVF) are the preferred access for hemodialysis. AVF occasionally develop venous aneurysms and we report a modified staple aneurysmorrhaphy technique for treatment. Briefly, the lateral wall of the venous aneurysm is dissected and a longitudinal staple resection performed. Adjunct procedures include inflow banding and outflow venous angioplasty with possible stenting. In this initial experience, 20 aneurysms were resected in 17 patients. The average AVF age at time of repair was 5...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887254/factors-affecting-patency-following-successful-percutaneous-intervention-for-dysfunctional-hemodialysis-vascular-access
#9
Sung Min Kim, Heung Kyu Ko, Minsu Noh, Gi-Young Ko, Min-Ju Kim, Tae-Won Kwon, Hee Jin Kim, Yong-Pil Cho
OBJECTIVE: This study aimed to investigate the patency following initial successful percutaneous transluminal angioplasty (PTA) for untreated dysfunctional hemodialysis vascular access and to identify predictors of PTA durability. METHODS: This retrospective observational study included data of 132 consecutive initial PTA of hemodialysis vascular access in 126 patients who showed immediate technical and clinical success and had at least 1 year of follow-up data...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28869934/typical-hemodialysis-in-india-a-case-report
#10
Georgi Abraham, Madhusudan Vijayan, Milly Mathew
We report here a typical case of a patient on hemodialysis (HD) for end-stage renal disease (ESRD) in India that highlights some of the management issues encountered in a country with an enormous burden of ESRD and major challenges of underdialysis and management of comorbidities. The patient, a 42-year-old multiparous woman with chronic kidney disease (CKD) stage V, type 2 diabetes mellitus, and hypertension is a homemaker from a middle-class family, living in a large city, with no family history of CKD. From May 2013 to December 2016, she has been receiving twice-weekly maintenance HD for 4 h (intermittent HD); access was via an internal jugular line initially and then via a left brachiocephalic arteriovenous fistula (AVF) from late June 2013...
2017: Blood Purification
https://www.readbyqxmd.com/read/28868755/matrix-metalloproteinase-2-predicts-arteriovenous-fistula-failure-in-hemodialysis-patients
#11
Dacian Călin Tirinescu, Ciprian Tomuleasa, Laura Pop, Cosmina Ioana Bondor, Dan Ştefan Vlăduţiu, Ioan Mihai Paţiu, Crina Claudia Rusu, Diana Tania Moldovan, Alina Potra, Ina Maria Kacsó
In hemodialysis patients the principal cause of arteriovenous fistula dysfunction is stenosis. Matrix-metalloproteinase-2 is implicated in the pathophysiological mechanism of stenosis development. Our study tried to assess the clinical impact of this protease on arteriovenous fistula survival. Seventy-nine prevalent dialysis patients with functional arteriovenous fistulas were included in the study. The presence of stenosis and the serum levels of matrix-metalloproteinase-2 were determined at the beginning of the study...
September 3, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28868296/hemodialysis-arteriovenous-access-occlusion-using-the-amplatzer-vascular-plug-in-patients-with-intractable-arm-edema
#12
Michele Di Filippo, Danilo Barbarisi, Doriana Ferrara, Stefania Brancaccio, Luca Del Guercio, Renata Bracale, Alfredo Capuano, Giovanni Esposito, Umberto Marcello Bracale
OBJECTIVES: Vascular occlusion of hemodialysis arteriovenous access (AVA) using an Amplatzer vascular plug (AVP; St. Jude Medical, St. Paul, MN, USA) is an arising and alternative practice in selected patients; however, few reported cases can be found in the literature. Herein, we report on our experience with endovascular treatment of complicated AVA. MATERIALS AND METHODS: From September 2015 to December 2016, 3 patients at our clinic underwent an occlusion of hemodialysis AVA with 2 different Amplatzer vascular plugs: 2 patients with type II and 1 patient with type IV...
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28867046/peritoneal-dialysis-catheter-placement-as-a-mode-of-renal-replacement-therapy-long-term-results-from-a-tertiary-academic-institution
#13
Ivy N Haskins, Martin Schreiber, Ajita S Prabhu, David M Krpata, Arielle J Perez, Luciano Tastaldi, Chao Tu, Michael J Rosen, Steven Rosenblatt
BACKGROUND: Peritoneal dialysis as a mode of renal replacement therapy still has not been embraced widely as an alternative to hemodialysis. Furthermore, there is marked variability in peritoneal dialysis catheter insertion techniques and perioperative management within the United States. After the publication of best-demonstrated practices for peritoneal dialysis catheter placement, the utilization of peritoneal dialysis has increased significantly at our institution. We detail the long-term success of peritoneal dialysis catheter placement after the adoption of best-demonstrated practices...
August 31, 2017: Surgery
https://www.readbyqxmd.com/read/28865977/safety-and-efficacy-of-polyurethane-vascular-grafts-for-early-hemodialysis-access
#14
John D Kakisis, Constantine Antonopoulos, George Mantas, Evaggelos Alexiou, Konstantina Katseni, George Sfyroeras, Konstantinos Moulakakis, George Geroulakos
BACKGROUND: Arteriovenous grafts made of polyurethane (PU) have the advantage of early cannulation obviating the placement of a central vein catheter in patients with an acute need for long-term hemodialysis. The aim of the present study was to evaluate the safety, efficacy and complication rate of PU vascular grafts for dialysis access in patients in whom early cannulation was performed. METHODS: Between January 2007 and December 2015, 125 straight brachial-axillary grafts were placed in patients with an acute thrombosis of a previous arteriovenous access...
August 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28865432/a-mixed-methods-investigation-of-incident-hemodialysis-access-in-a-safety-net-population
#15
Nicole C Rich, Shant M Vartanian, Shimi Sharief, Daniel J Freitas, Delphine S Tuot
BACKGROUND: Despite improved health outcomes associated with arteriovenous fistulas, 80% of Americans initiate hemodialysis using a catheter, influenced by low socioeconomic status among other factors. Risk factors for incident catheter use in safety-net populations are unknown. Our objective was to identify factors associated with incident catheter use among hemodialysis patients at one safety-net hospital, with a goal of informing fistula placement initiatives targeted at safety-net populations more generally...
September 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28862725/longitudinal-dialysis-adequacy-and-clinical-performance-of-the-vectorflow-hemodialysis-catheter-a-prospective-study
#16
John R Ross, Tatiana A Puga, Thomas E Philbeck
PURPOSE: To report clinical performance and longitudinal assessment of hemodialysis adequacy with the Arrow-Clark VectorFlow catheter, a symmetrical-tip device with a distal lumen configuration designed to reduce platelet shear stress and catheter thrombosis. METHODS AND MATERIALS: We prospectively enrolled patients who required de novo placement of a chronic tunneled catheter for hemodialysis or exchange of a dysfunctional catheter as part of an Institutional Review Board (IRB)-approved protocol...
August 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28860634/deficiency-of-tlr4-homologue-rp105-aggravates-outward-remodeling-in-a-murine-model-of-arteriovenous-fistula-failure
#17
Taisiya Bezhaeva, ChunYu Wong, Margreet R de Vries, Eric P van der Veer, Carla M A van Alem, Ivo Que, Reshma A Lalai, Anton-Jan van Zonneveld, Joris I Rotmans, Paul H A Quax
Arteriovenous access dysfunction is a major cause of morbidity for hemodialysis patients. The pathophysiology of arteriovenous fistula (AVF) maturation failure is associated with inflammation, impaired outward remodeling (OR) and intimal hyperplasia. RP105 is a critical physiologic regulator of TLR4 signaling in numerous cell types. In the present study, we investigated the impact of RP105 on AVF maturation, and defined cell-specific effects of RP105 on macrophages and vascular smooth muscle cells (VSMCs). Overall, RP105(-/-) mice displayed a 26% decrease in venous OR...
August 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28856871/pfannenstiel-laparoendoscopic-reduced-port-bilateral-radical-nephrectomy-for-a-patient-with-renal-cell-carcinoma-undergoing-hemodialysis
#18
Takeo Nomura, Mutsushi Yamasaki, Kohei Takei, Fuminori Sato, Toshiro Terachi, Hiromitsu Mimata
We performed Pfannenstiel laparoendoscopic reduced-port bilateral radical nephrectomy on a patient with renal cell carcinoma undergoing hemodialysis. A 4-cm Pfannenstiel incision was made, and a GelPOINT access was inserted. Three trocars were placed through the access platform, and additional 5- and 3-mm trocars were inserted in the umbilicus and paraumbilical area, respectively. After left nephrectomy, right nephrectomy was successfully completed in 401 min, with an estimated blood loss of 70 mL. There were no intraoperative or postoperative complications, and the patient was discharged 10 days postoperatively...
August 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28856008/when-crrt-on-ecmo-is-not-enough-for-potassium-clearance-a-case-report
#19
Janice A Tijssen, Guido Filler
BACKGROUND: Continuous renal replacement therapy (CRRT) is an excellent method used to remove fluid and solutes. It may also reduce the systemic inflammatory response for patients on extracorporeal membrane oxygenation (ECMO) support. The objective of this report is to describe a case where CRRT in combination with ECMO was insufficient to control hyperkalemia. METHODS: We report the case of an adolescent patient with refractory symptomatic hyperkalemia due to substantial rhabdomyolysis in which CRRT insufficiently cleared the patient's excess potassium...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28854521/substitution-rate-based-screening-model-to-assess-stenosis-progression-in-experimental-stenotic-arteriovenous-grafts
#20
Chung-Dann Kan, Wei-Ling Chen, Chia-Hung Lin, Ming-Jui Wu, Yi-Chen Mai
An arteriovenous graft (AVG) has a higher patency rate in stenosis progression at the venous anastomosis site, which causes coexisting inflow and outflow stenoses. This leads to increases in blood pressure, flow velocity, and flow resistance, resulting in hemodialysis (HD) vascular access dysfunction from early clots and thrombosis to the progression of coexisting stenoses. To prevent vascular access complications such as inflow or outflow stenoses, this study proposes a novel examination method in an experimental AVG system using a substitution-rate based screening model...
August 15, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
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