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Vascular access dialysis

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https://www.readbyqxmd.com/read/28238919/characteristics-management-and-outcomes-of-surgically-treated-arteriovenous-fistula-aneurysm-in-patients-on-regular-hemodialysis
#1
Hassan Al-Thani, Ayman El-Menyar, Noora Al-Thani, Mohammad Asim, Ahmed Hussein, Ahmed Sadek, Ahmed Sharaf, Amr Fares
BACKGROUND: To investigate the clinical characteristics, surgical interventions and outcomes of arteriovenous fistula (AVF) aneurysms, we retrospectively analyzed patients on regular hemodialysis (HD). METHODS: We conducted a cohort study of all patients with HD access who presented with AVF aneurysms and underwent operative procedures over a 11-year period. Patients' demographics, comorbidities, vascular access characteristics, management of aneurysms, complications and outcomes were analyzed...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28238554/developing-a-set-of-core-outcomes-for-trials-in-hemodialysis-an-international-delphi-survey
#2
Nicole Evangelidis, Allison Tong, Braden Manns, Brenda Hemmelgarn, David C Wheeler, Peter Tugwell, Sally Crowe, Tess Harris, Wim Van Biesen, Wolfgang C Winkelmayer, Benedicte Sautenet, Donal O'Donoghue, Helen Tam-Tham, Sajeda Youssouf, Sreedhar Mandayam, Angela Ju, Carmel Hawley, Carol Pollock, David C Harris, David W Johnson, Dena E Rifkin, Francesca Tentori, John Agar, Kevan R Polkinghorne, Martin Gallagher, Peter G Kerr, Stephen P McDonald, Kirsten Howard, Martin Howell, Jonathan C Craig
BACKGROUND: Survival and quality of life for patients on hemodialysis therapy remain poor despite substantial research efforts. Existing trials often report surrogate outcomes that may not be relevant to patients and clinicians. The aim of this project was to generate a consensus-based prioritized list of core outcomes for trials in hemodialysis. STUDY DESIGN: In a Delphi survey, participants rated the importance of outcomes using a 9-point Likert scale in round 1 and then re-rated outcomes in rounds 2 and 3 after reviewing other respondents' scores...
February 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28236920/bovine-carotid-artery-biologic-graft-outperforms-expanded-polytetrafluoroethylene-for-hemodialysis-access
#3
Isibor Arhuidese, Thomas Reifsnyder, Tasnim Islam, Omar Karim, Besma Nejim, Tammam Obeid, Umair Qazi, Mahmoud Malas
OBJECTIVE: Arteriovenous grafts remain reliable substitutes for permanent hemodialysis access in patients without a suitable autogenous conduit. Advances in conduit design and endovascular management of access-related complications question the preference for synthetic conduits over biologic grafts in contemporary practice. In this study, we compared outcomes between a bovine carotid artery (BCA) biologic graft and expanded polytetrafluoroethylene (ePTFE) grafts for hemodialysis access in a recent cohort of patients...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28229924/outcomes-in-adults-and-children-with-end-stage-kidney-disease-requiring-dialysis-in-sub-saharan-africa-a-systematic-review
#4
Gloria Ashuntantang, Charlotte Osafo, Wasiu A Olowu, Fatiu Arogundade, Abdou Niang, John Porter, Saraladevi Naicker, Valerie A Luyckx
BACKGROUND: The burden of end-stage kidney disease (ESKD) in sub-Saharan Africa is unknown but is probably high. Access to dialysis for ESKD is limited by insufficient infrastructure and catastrophic out-of-pocket costs. Most patients remain undiagnosed, untreated, and die. We did a systematic literature review to assess outcomes of patients who reach dialysis and the quality of dialysis received. METHODS: We searched PubMed, African Journals Online, WHO Global Health Library, and Web of Science for articles in English or French from sub-Saharan Africa reporting dialysis outcomes in patients with ESKD published between Jan 1, 1990, and Dec 22, 2015...
February 17, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28222990/establishing-patient-specific-criteria-for-selecting-the-optimal-upper-extremity-vascular-access-procedure
#5
Karen Woo, Jesus Ulloa, Michael Allon, Christopher G Carsten, Eric S Chemla, Mitchell L Henry, Thomas S Huber, Jeffrey H Lawson, Charmaine E Lok, Eric K Peden, Larry Scher, Anton Sidawy, Melinda Maggard-Gibbons, David Cull
OBJECTIVE: The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dramatically, several reports have found that this singular focus on increasing AVFs has resulted in increased AVF nonmaturation/early failure and a high prevalence of catheter dependence...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222688/vascular-access-conversion-and-patient-outcome-after-hemodialysis-initiation-with-a-nonfunctional-arteriovenous-access-a-prospective-registry-based-study
#6
Natalia Alencar de Pinho, Raphael Coscas, Marie Metzger, Michel Labeeuw, Carole Ayav, Christian Jacquelinet, Ziad A Massy, Bénédicte Stengel
BACKGROUND: Little is known about vascular access conversion and outcomes for patients starting hemodialysis with nonfunctional arteriovenous (AV) access. We assessed mortality risk associated with nonfunctional AV access at hemodialysis initiation, taking subsequent changes in vascular access into account. METHODS: We studied the 53,092 incident adult hemodialysis patients included in the French REIN registry from 2005 through 2012. AV access placed predialysis was considered nonfunctional when dialysis began with a central venous catheter...
February 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28218365/a-comparison-of-efficacy-of-endovascular-versus-surgical-repair-for-the-treatment-of-arteriovenous-fistula-stenosis-in-taiwan
#7
Szu-Shan Fan, Chien-Wen Chen, Kuo-Cheng Lu, Hung-Chung Mao, Miao-Pei Chen, Chu-Lin Chou
BACKGROUND: Percutaneous transluminal angioplasty (PTA) and fistula reconstruction surgery are therapeutic options for vascular access occlusion in hemodialysis patients. However, owing to its convenience, PTA has gradually become the preferred therapeutic option for fistula stenosis or occlusion. This study investigated the effects of the two therapeutic methods on the vascular access maintenance duration (number of days) and maintenance costs of fistula in dialysis patients from different dialysis units...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28218361/arteriovenous-fistula-maturation-in-patients-with-permanent-access-created-prior-to-or-after-hemodialysis-initiation
#8
Juan C Duque, Laisel Martinez, Marwan Tabbara, Denise Dvorquez, Sushil K Mehandru, Arif Asif, Roberto I Vazquez-Padron, Loay H Salman
INTRODUCTION: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#9
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28213931/successful-resumption-of-peritoneal-dialysis-following-living-donor-liver-transplantation-in-children-with-end-stage-renal-disease
#10
Hiroyuki Kanazawa, Akinari Fukuda, Mai Sato, Shingo Ishimori, Kengo Sasaki, Hajime Uchida, Takanobu Shigeta, Vidyadhar Padmakar Mali, Seisuke Sakamoto, Kenji Ishikura, Mureo Kasahara
Children with ESRD in need of RRT are commonly managed by PD due to difficulty with vascular access for HD and the relatively large extracorporeal blood volume required. Major abdominal surgery may result in injury to the peritoneum and consequent adhesion, thereby resulting in a reduction in the anatomical capacity and transport capability across the peritoneal membrane. Here, we report successful resumption of PD after LDLT in two pediatric patients. The causes of ESRD were PH1 and juvenile nephronophthisis, respectively...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28183219/cilostazol-may-improve-maturation-rates-and-durability-of-vascular-access-for-hemodialysis
#11
Todd E Russell, Gregory C Kasper, Andrew J Seiwert, Anthony J Comerota, Fedor Lurie
Cilostazol is effective in controlling pathophysiological pathways similar or identical to those involved in nonmaturation and failure of the arteriovenous access. This case-control study examined whether cilostazol would improve maturation rates and durability of vascular access for hemodialysis. The treatment group included 33 patients who received cilostazol for ≥30 days prior to creation of a dialysis access and continued with cilostazol therapy for ≥60 days after surgery. The matched (gender, age, race, diabetes, and the year of surgery) control group included 116 patients who underwent the same procedure but did not receive cilostazol prior to and at least 3 months after surgery...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28182039/hemodialysis-outcomes-and-practice-patterns-in-end-stage-renal-disease-experience-from-a-tertiary-care-hospital-in-kerala
#12
G R Lakshminarayana, L G Sheetal, A Mathew, R Rajesh, G Kurian, V N Unni
This study was planned to analyze the hemodialysis practice patterns from a tertiary care referral centre as there is very limited data from India. All patients of ESRD on maintenance hemodialysis (MHD) in dialysis unit at AIMS, Kochi, Kerala for a minimum period of 3 months were included. A total of 134 patients (M: F 2:1) with age of 20 to 84 years (Mean: 59.83; SD: 11.98) were studied. The most common causes of ESRD in study population were diabetic nephropathy (DN) (59.7%) followed by unclassified group (19...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28165577/surgical-reconstruction-of-central-venous-obstruction-in-salvaging-upper-extremity-dialysis-accesses
#13
Jurabek Babadjanov, Rick Bernstein, Lee Kirksey
BACKGROUND: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. METHODS: We report a case of symptomatic arm swelling secondary to central vein stenosis and failed endovascular venous intervention treated by central vein bypass with prosthetic graft through median sternotomy...
February 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28151412/a-trial-of-extending-hemodialysis-hours-and-quality-of-life
#14
Meg J Jardine, Li Zuo, Nicholas A Gray, Janak R de Zoysa, Christopher T Chan, Martin P Gallagher, Helen Monaghan, Stuart M Grieve, Rajesh Puranik, Hongli Lin, Josette M Eris, Ling Zhang, Jinsheng Xu, Kirsten Howard, Serigne Lo, Alan Cass, Vlado Perkovic
The relationship between increased hemodialysis hours and patient outcomes remains unclear. We randomized (1:1) 200 adult recipients of standard maintenance hemodialysis from in-center and home-based hemodialysis programs to extended weekly (≥24 hours) or standard (target 12-15 hours, maximum 18 hours) hemodialysis hours for 12 months. The primary outcome was change in quality of life from baseline assessed by the EuroQol 5 dimension instrument (3 level) (EQ-5D). Secondary outcomes included medication usage, clinical laboratory values, vascular access events, and change in left ventricular mass index...
February 1, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28127730/factors-influencing-dialysis-arteriovenous-graft-survival
#15
Anna Valerianova, Jaroslav Kudlicka, Eva Chytilova, Barbora Grauova, Zdislava Krupickova, Jan Malik
PURPOSE: Dysfunction and loss of patency of dialysis arteriovenous grafts (AVGs) are serious causes of morbidity in patients on dialysis. Various risk factors associated with shorter AVG patency have been blamed, but the results of the studies were controversial. The aim of this study was to assess if associated diseases, biochemical markers and other parameters associated with atherosclerosis influence patency of AVGs in a large vascular access centre. METHODS: We conducted a retrospective study that included patients with AVGs patent for at least 3 weeks after creation...
January 24, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28124305/calcification-in-arteriovenous-fistula-blood-vessels-may-predict-arteriovenous-fistula-failure-a-5-year-follow-up-study
#16
Aleksandar Jankovic, Tatjana Damjanovic, Zivka Djuric, Jelena Marinkovic, Georg Schlieper, Petar Djuric, Jelena Tosic Dragovic, Ana Bulatovic, Milos Mitrovic, Jovan Popovic, Jürgen Floege, Nada Dimkovic
PURPOSE: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. The impact of vascular calcification process on AVF survival remains unclear and results of several studies about this issue are controversial. In the light of the new knowledge about the different susceptibility for calcification process in different blood vessels, the aim of our study was to analyze whether the calcification of AVF-blood vessels may have an impact on AVF longevity. METHODS: The study included 90 patients, 49 males and 41 females, all of them Caucasians, with a mean age 62 ± 11 years, on regular hemodialysis for more than 1 year with patent primary AVFs...
January 25, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28110327/mortality-after-renal-allograft-failure-and-return-to-dialysis
#17
Amarpali Brar, Mariana Markell, Dimitre G Stefanov, Edem Timpo, Rahul M Jindal, Robert Nee, Nabil Sumrani, Devon John, Fasika Tedla, Moro O Salifu
INTRODUCTION: The outcomes of patients who fail their kidney transplant and return to dialysis (RTD) has not been investigated in a nationally representative sample. We hypothesized that variations in management of transplant chronic kidney disease stage 5 leading to kidney allograft failure (KAF) and RTD, such as access, nutrition, timing of dialysis, and anemia management predict long-term survival. METHODS: We used an incident cohort of patients from the United States Renal Data System who initiated hemodialysis between January 1, 2003 and December 31, 2008, after KAF...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#18
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
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
#19
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/28074626/radio-cephalic-fistula-recovered-with-drainage-to-forearm-basilic-vein
#20
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
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