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https://www.readbyqxmd.com/read/29192721/haemodialysis-vascular-access-current-practices-amongst-indian-nephrologists
#1
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#2
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#3
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#4
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29029967/-10-years-of-external-quality-assurance-in-dialysis-in-germany-results-and-future-prospects
#5
Dorothea Büchtemann, Stefan Meinhold, Peter Follert
BACKGROUND: In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme based on the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres...
October 10, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28843984/arteriovenous-fistulae-for-haemodialysis-a-systematic-review-and-meta-analysis-of-efficacy-and-safety-outcomes
#6
REVIEW
L C Bylsma, S M Gage, H Reichert, S L M Dahl, J H Lawson
BACKGROUND: Arteriovenous fistulae are the currently recommended gold standard vascular access modality for haemodialysis because of their prolonged patency, improved durability, and low risk of infection for those that mature. However, notable disadvantages are observed in terms of protracted maturation time, associated high rates of catheter use, and substantial abandonment rates. The aim of this study was to quantitatively summarize the outcomes of fistula patency, infection, maturation, and abandonment published in the scientific literature...
October 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28833793/impact-of-simulation-based-learning-on-immediate-outcomes-of-temporary-haemodialysis-catheter-placements-by-nephrology-fellows
#7
Ru Yu Tan, Kian Guan Lee, Sheryl Wen Shien Gan, Huihua Li, Wenxiang Yeon, Suh Chien Pang, Swee Ping Teh, Htay Htay, Su Hooi Teo, Jia Liang Kwek, Pei Loo Tok, Cheng Boon Poh, Chee Yong Ng, Peiyun Liu, Hui Boon Tay, Riece Koniman, Marjorie Wai Yin Foo, Lina Hui Lin Choong, Chieh Suai Tan
AIM: Traditional apprenticeship model (AM) of teaching in invasive procedures such as temporary haemodialysis catheter (THDC) insertion can result in propagation of errors and complications. Simulation-based learning (SBL) offers standardization of skills and allows trainees to repeatedly practice invasive procedures prior to performing them on actual patient. METHODS: Retrospective cohort study of first-, second- and third-year Nephrology Fellows from a tertiary teaching hospital from September 2008 to September 2015...
August 18, 2017: Nephrology
https://www.readbyqxmd.com/read/28815975/urea-based-recirculation-validation-of-the-symmetrical-palindrome-catheter
#8
Martin Jonczyk, Christian Althoff, Torsten Slowinski, Ina Lieker, Marcel Naik, Jonas Auer, Raúl García Marcos, Ejona Duka, Bernd Hamm, Maximilian de Bucourt
BACKGROUND: High blood flow and low recirculation rates are central for adequate haemodialysis. A new symmetrical tip has been invented promising efficient haemodialysis even if the ports are reversed. OBJECTIVE: To evaluate access recirculation of the 'palindrome' catheter and to report initial experiences in a clinical setting. MATERIAL AND METHODS: After implantation of the new catheter in 20 patients (male: 14; female: 6; mean age 72 ± 12...
December 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28731490/lancisi-s-sign-and-central-venous-catheter-tip-position-a-case-report
#9
Valentina Vigo, Piero Lisi, Giuseppe Galgano, Carlo Lomonte
INTRODUCTION: Valvular disease and pulmonary hypertension are common conditions in haemodialysis patients. In presence of tricuspid regurgitation, an increased retrograde blood flow into the right atrium during ventricle systole results in a typical modification of the normal venous waveform, creating a giant c-v wave. This condition clinically appears as a venous palpable pulsation within the internal jugular vein, also known as Lancisi's sign. CASE REPORT: An 83-year-old woman underwent haemodialysis for 9 years...
July 19, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28691599/sheep-model-of-haemodialysis-treatment
#10
Jolanta Bujok, Tomasz Walski, Albert Czerski, Katarzyna Gałecka, Karolina Grzeszczuk-Kuć, Wojciech Zawadzki, Wojciech Witkiewicz, Małgorzata Komorowska
More than two million patients received haemodialysis (HD) in 2013. Many methods for improving dialysis therapy outcomes have been tested. Nevertheless, patients continue to experience high morbidity and mortality rates. We aimed to develop an animal model of HD treatment to study methods that would prevent the adverse effects of renal replacement therapy. The study was conducted using six male Merino sheep. The animals underwent a two-step bilateral nephrectomy, and a permanent dual-lumen catheter was inserted into the jugular vein...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28665465/outcomes-of-a-nephrologist-driven-tunnelled-dialysis-catheter-insertion-service-in-south-east-asia
#11
Milind Nikam, Claude J Renaud, Joshua Shaowen Lee, Sri Fairuz B Saifful, Allen Yan Lun Liu, Eng Kuang Lim, Ying Ying Seow, Lee Ying Yeoh
INTRODUCTION: Tunnelled dialysis catheters (TDCs) are being increasingly inserted by nephrologists globally but there is limited experience and paucity of published outcomes data from South-East Asia (SEA). This study was conducted to analyse the outcomes of TDC insertion by nephrologists from a single centre in SEA. METHODS: All patients who underwent TDC insertion by nephrologists from October 2013 to June 2016 were included. TDC survival was calculated using Kaplan-Meier survival method...
July 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28653946/the-truth-on-current-peritoneal-dialysis-state-of-the-art
#12
R T Krediet, A C Abrahams, C W H de Fijter, M G H Betjes, W H Boer, B C van Jaarsveld, C J A M Konings, F W Dekker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased markedly in the Netherlands in the last 15 years. Consequently, the knowledge of nephrologists and nursing staff on PD has declined leading to a negative spiral in which loss of experience resulted in loss of enthusiasm to offer PD to patients and also in less interest in the new PD developments. All these changes took place while the results of PD improved and patient survival was at least similar to that on haemodialysis...
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28642998/plastic-bronchitis-a-rare-complication-of-long-term-haemodialysis-catheter-placement-in-a-child
#13
Simon Carter, Dayna van de Hoef, Michael Temple, Elizabeth Harvey, Suhail Al-Saleh, Christoph Licht, Damien Noone
BACKGROUND: Despite peritoneal dialysis being the preferred mode of renal replacement therapy in neonates and infants, long-term haemodialysis may be necessary in a minority of patients with its attendant risks. CASE DIAGNOSIS/TREATMENT: This case identifies plastic bronchitis as a rare yet serious complication of long-term large bore vascular access when a vessel-sparing approach is not possible. CONCLUSIONS: An appropriately sized catheter should be used for the dialytic therapy required and to optimize access survival...
June 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28604317/beware-the-femoral-haemodialysis-catheter-a-surgeon-s-perspective
#14
Tinus Du Toit, David Thomson, Elmi Muller
The ability to identify and address factors that threaten the optimal utilisation of donor organs is quintessential in obtaining satisfactory transplant outcomes. We share our concerns regarding the prolonged use of femoral haemodialysis catheters and its potential to jeopardise successful renal transplantation. Despite a paucity of literature on the topic, we review relevant aspects related to this pernicious form of vascular access and clarify its limited role in the modern haemodialysis unit, particularly in patients who are still considered for transplantation...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28508973/phlegmasia-cerulean-dolens-complication-of-femoral-vein-catheterization
#15
M Hari Krishna Reddy, B Sangeetha, M Aruna, V Sarat Chandra, Anil C Venkata Kumar, R Ram, V Sivakumar
There are three less frequent manifestations of acute massive venous thrombosis and obstruction of the venous drainage of an extremity. They are phlegmasia alba dolens, phlegmasia cerulean dolens (PCD), and venous gangrene. The term PCD differentiates ischemia-associated massive venous thrombosis from phlegmasia alba dolens, which describes fulminant venous thrombosis without ischemia. We present a 55-year-old hypertensive, who presented with paedal oedema and breathlessness at rest. About a month prior to this admission, she suffered dislocation of left patella...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28491228/-survival-among-chronic-hemodialysed-patient-in-cameroon
#16
MULTICENTER STUDY
Hermine Fouda, Gloria Ashuntantang, François Kaze, Marie-Patrice Halle
INTRODUCTION: Haemodialysis is the only renal replacement therapy available in Cameroon; 95% of patients has received subsidies by the State since 2002 and the number of dialysis centers is growing. However, since the opening of the first center in 1990, there are no data on survival in chronic dialysis patients. METHODS: We conducted a multicenter prospective cohort study of 15 months in order to assess mortality rates and factors that influence the survival of chronic hemodialysis patients in Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28393467/patient-perspectives-on-the-optimal-start-of-renal-replacement-therapy
#17
Shayna L Henry, Corrine Munoz-Plaza, Jazmine Garcia Delgadillo, Nichole K Mihara, Mark P Rutkowski
BACKGROUND: Healthcare systems and providers are encouraged to prepare their patients with advanced chronic kidney disease (CKD) for a planned start to renal replacement therapies (RRT). Less well understood are the socioemotional experiences surrounding the optimal start of RRT versus suboptimal haemodialysis (HD) starts with a central catheter. OBJECTIVES: To characterise the experiences of patients beginning RRT. DESIGN: Qualitative, semi-structured phone interviews...
September 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28342461/-the-infection-risk-assessment-visit-in-haemodialysis-a-new-tool
#18
REVIEW
Élisabeth Laprugne-Garcia, Sophie Gardes
Haemodialysis is a speciality with a high risk of infection, due in part to the frailty of the patients (immunosuppressed, high prevalence of carriers of multi-drug resistant bacteria), as well as to the invasive procedures carried out (inserting central venous catheters, using these catheters and arteriovenous fistulas). The infection risk assessment visit in haemodialysis is a tool which contributes to the safety of care.
March 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28339843/availability-and-cost-of-extracorporeal-treatments-for-poisonings-and-other-emergency-indications-a-worldwide-survey
#19
Josée Bouchard, Valery Lavergne, Darren M Roberts, Monique Cormier, Genevieve Morissette, Marc Ghannoum
Background: Extracorporeal treatments (ECTRs) are used for different conditions, including replacement of organ function and poisoning. Current recommendations for ECTRs in various poisonings suggest that intermittent haemodialysis (IHD) is the most efficient technique. However, the practicality of these recommendations is poorly defined in view of limited information on availability and cost worldwide. Methods: A survey invitation to an Internet-based questionnaire was emailed between January 2014 and March 2015 to members of international societies to determine the availability, time to initiation and cost of ECTRs (including filters, dialysate, catheter, anticoagulant and nursing/physician salary)...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28297052/patient-factors-and-haemodialysis-arteriovenous-fistula-outcomes
#20
REVIEW
Agnes Masengu, Jennifer Hanko
Arteriovenous fistulas (AVF) improve survival and morbidity for most haemodialysis (HD) patients. Are they better for all patients? In the enthusiastic pursuit of AVFs for all, concerns have been raised regarding high primary AVF failure rates, continued high incident central venous catheter (CVC) use in some countries, and the limited life expectancy of some HD patients. "Fistula first" is changing to "catheter last". The focus must be on decreasing AVF failure to mature and decreasing incident CVC use. An optimal outcome should be sought for each individual patient, and multiple failed attempts at AVF creation avoided...
March 6, 2017: Journal of Vascular Access
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