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Vascular access dialysis

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https://www.readbyqxmd.com/read/29784566/preoperative-point-of-care-ultrasound-and-its-impact-on-arteriovenous-fistula-maturation-outcomes
#1
Sajjid Hossain, Amit Sharma, Luc Dubois, Guy DeRose, Audra Duncan, Adam H Power
OBJECTIVE: Duplex ultrasound as a preoperative assessment tool in the clinic may help identify anatomic factors predictive of fistula maturation. Preoperative point-of-care ultrasound (POCUS) offers surgeons an alternative to routine formal vein mapping as it can be performed by the operator during the initial clinic visit. We sought to determine the impact of POCUS as an adjunct to physical examination on arteriovenous fistula maturation. METHODS: All consecutive patients undergoing first-time dialysis access creation from December 2007 to December 2014 were retrospectively reviewed...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29758323/why-do-vascular-surgeons-get-sued-analysis-of-claims-and-outcomes-in-malpractice-litigation
#2
John Phair, Eric B Trestman, Eddie Skripochnik, Evan C Lipsitz, Issam Koleilat, Larry A Scher
OBJECTIVE: To analyze causes and outcomes of malpractice claims against vascular surgeons in the United States. METHODS: Cases entered into the Westlaw database from January 1st 1999 to December 31st 2014 were reviewed. Search terms "vascular" and "surgeon" were used. Data was compiled on the allegation, subject matter and outcome of each case. Additional data including demographics of the defendant was obtained from U.S. News Health Reports on practicing physicians...
May 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29736915/planning-and-evaluation-for-vascular-access-in-the-elderly
#3
Candice Halinski, Holly M Koncicki
Vascular access is of vital importance for patients requiring dialysis therapies. AV fistulas have been endorsed by many professional societies as the access of choice, however, subsequent creation does not go without consequences. As the population ages and patients become more medically complex, access failure has become a major cause of treatment complication. For the elderly, this is especially true and there are multiple decision points that require careful reflection before an AVF is placed. This article reviews access considerations for AVF placement in the elderly population and considers the possibility that the fistula first approach to vascular access should not be an absolute...
May 8, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29724122/a-meta-analysis-of-the-association-between-diabetic-patients-and-avf-failure-in-dialysis
#4
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/29703700/improved-patency-of-eptfe-grafts-as-a-hemodialysis-access-site-by-seeding-autologous-endothelial-cells-expressing-fibulin-5-and-vegf
#5
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
#6
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/29701407/creative-vascular-access-construction-in-same-patient
#7
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
#8
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/29689520/brachiocephalic-a-v-fistula-through-the-median-cubital-vein-a-reliable-option-to-failure-of-forearm-fistulas-a-case-report-from-chu-yaound%C3%A3
#9
Marc Leroy Guifo, Denis Georges Teuwafeu, Motto Georges Bwelle, Guy Aristide Bang, Mefiré Alain Chichom, Aurelien Ndoumbe, Arthur Georges Essomba
INTRODUCTION: Renal replacement therapy in end-stage kidney disease relies on dialysis in low-income countries. This maintenance treatment needs a reliable vascular access and is done through central venous catheter or creation of A-V fistulas. Several types of A-V fistulas can be done but due to some individual conditions, those possibilities may be exhausted rapidly. CASE PRESENTATION: A 31 year old female was diagnosed with an end stage renal disease for which she was prescribed maintenance dialysis...
April 18, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29680297/early-results-of-percutaneous-arteriovenous-fistula-creation-with-the-ellipsys-vascular-access-system
#10
Alexandros Mallios, William C Jennings, Benoit Boura, Alessandro Costanzo, Pierre Bourquelot, Myriam Combes
OBJECTIVE: We reviewed our initial experience creating a percutaneous arteriovenous fistula (pAVF) using a thermal resistance anastomosis device with proximal radial artery inflow. METHODS: A retrospective review was conducted of all patients who underwent a pAVF creation procedure between May 2017 and October 2017. Primary end points of the study were technical success, patency by Doppler ultrasound examination or angiography, flow levels achieved, time to first use, and pAVF-related complications...
April 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29668211/a-payer-provider-partnership-for-integrated-care-of-patients-receiving-dialysis
#11
Justin Kindy, David Roer, Robert Wanovich, Stephen McMurray
OBJECTIVES: Patients with end-stage renal disease (ESRD) are clinically complex, requiring intensive and costly care. Coordinated care may improve outcomes and reduce costs. The objective of this study was to determine the impact of a payer-provider care partnership on key clinical and economic outcomes in enrolled patients with ESRD. STUDY DESIGN:  Retrospective observational study. METHODS: Data on patient demographics and clinical outcomes were abstracted from the electronic health records of the dialysis provider...
April 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29656848/the-discipline-of-epidemiology-engaging-in-the-full-breadth-of-population-health-science
#12
Harold I Feldman
This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology...
March 21, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29642730/long-term-outcomes-of-bovine-pericardial-patch-angioplasty-for-recurrent-stenosis-in-vascular-access-a-uk-single-centre-experience
#13
Owain Fisher, Lewis Meecham, Pauline Buxton, Jocelyn Legge, Jack Fairhead, Sriram Rajagopalan, John Asquith, Arun Pherwani
INTRODUCTION: Stenosis of an arteriovenous fistula or arteriovenous graft for dialysis is a common problem. Stenosis may lead to a number of problems including failure of the fistula. Treatment of stenosis is commonly with percutaneous angioplasty or surgical patch angioplasty with autologous vein or synthetic graft or patch. Here we report the use of bovine pericardial patch angioplasty as an alternative mode of patch angioplasty when percutaneous intervention has failed. METHODS: Patients with fistulae treated with bovine patch angioplasty between 2013 and 2016 were identified from a prospectively maintained renal access database (Cyberren® )...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29629274/current-characteristics-of-dialysis-therapy-in-korea-2016-registry-data-focusing-on-diabetic-patients
#14
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park, Yong-Kyun Kim
Diabetic nephropathy is the most frequent cause of end-stage renal disease worldwide. Dialysis patients with diabetes mellitus (DM) have more complications and shorter survival duration than non-DM dialysis patients, requiring more clinical attention and difficult management. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an on-line registry program and analyzed the characteristics of patients. A survey of dialysis patients in 2016 showed that 50...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29629273/korean-clinical-practice-guidelines-for-preventing-the-transmission-of-infections-in-hemodialysis-facilities
#15
Hayne Cho Park, Young-Ki Lee, Kyung Don Yoo, Hee Jung Jeon, Seung Jun Kim, Ajin Cho, Jacob Lee, Yang-Gyun Kim, Sang-Ho Lee, Sang-Oh Lee
Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential infections, each hemodialysis unit should establish and follow standard infection control and prevention measures. Therefore, clinical practice guidelines were developed by a working group of nephrologists and infection control specialists to provide evidence-based guidance for dialysis physicians and nurses, with the aim of preventing infection transmission and controlling infection sources in hemodialysis facilities...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29622355/a-prospective-randomized-study-of-stent-graft-placement-after-balloon-angioplasty-versus-balloon-angioplasty-alone-for-the-treatment-of-hemodialysis-patients-with-prosthetic-graft-outflow-stenosis
#16
Hsuan-Tzu Yang, Sheng-Yueh Yu, Ta-Wei Su, Tsung-Chi Kao, Hung-Chang Hsieh, Po-Jen Ko
BACKGROUND: Hemodialysis graft outflow stenosis is a significant complication occurring in hemodialysis patients with prosthetic grafts for vascular access. Balloon angioplasty remains the first-line endovascular treatment of this complication, although covered stent graft implantation after balloon angioplasty also appears to be an effective and promising treatment. The aim of this study was to evaluate the efficacy and durability of stent graft placement after balloon angioplasty in comparison to balloon angioplasty alone for the treatment of graft outflow stenosis in hemodialysis patients...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29615168/reasons-for-removal-of-non-tunneled-double-lumen-catheters-in-incident-dialysis-patients
#17
Ruqaya Qureshi, Beena Salman, Salman Imtiaz, Murtaza F Drohlia, Aasim Ahmad
OBJECTIVE: To evaluate the reasons of removal of non-tunneled double lumen catheters (NTDLC) in incident hemodialysis (HD) patients in a tertiary renal care hospital. STUDY DESIGN: Observational retrospective study. PLACE AND DURATION OF STUDY: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKC PGTI), Karachi, from June 2015 to May 2016. METHODOLOGY: All patients were selected who had naive NTDLC placement at TKC PGTI either in Emergency Room (ER) or Intensive Care Unit (ICU) during the study period...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29614907/haemodialysis-access-thrombosis-outcomes-after-surgical-thrombectomy-versus-catheter-directed-thrombolytic-infusion
#18
Linn Koraen-Smith, Matteus Krasun, Matteo Bottai, Ulf Hedin, Carl M Wahlgren, Peter Gillgren
INTRODUCTION: Thrombosis is one of the most common complications of dialysis vascular access and is a significant source of morbidity and healthcare-associated costs. In this retrospective study, outcomes for surgical thrombectomy and thrombolysis after access thrombosis in patients with arteriovenous fistulas or prosthetic grafts (arteriovenous grafts) were analysed. METHODS: All patients with a primary episode of dialysis access thrombosis between 2005 and 2013 were included which yielded 131 patients with 149 episodes of access thrombosis (108 arteriovenous grafts; 41 arteriovenous fistulas)...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29609535/prevalence-and-correlates-of-central-venous-catheter-use-among-haemodialysis-patients-in-the-irish-health-system-a-national-study
#19
Wael F Hussein, Husham Mohammed, Leonard Browne, Liam Plant, Austin G Stack
BACKGROUND: Central venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for many patients on HD. The goal of this study was to determine the prevalence and variation in CVC use across centres in the Irish health system. METHODS: Data from the National Kidney Disease Clinical Patient Management System (KDCPMS) was used to determine CVC use and patterns across centres...
April 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29606268/-incremental-haemodialysis
#20
Cécile Courivaud
The majority of incidental haemodialysis patients are systematically treated at the rate of three sessions per week, regardless of their level of residual kidney function. Incremental haemodialysis is a therapeutic strategy adapted to the residual kidney function level of each patient, to offer patients only the "dialysis dose" needed to supplement their residual kidney function, while ensuring that they achieve the objective of total clearance (renal+per-HD) recommended (weekly Standard Kt/V urea>2...
April 2018: Néphrologie & Thérapeutique
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