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https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#1
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27861462/at-which-stage-of-end-stage-kidney-disease-should-chronic-dialysis-be-started
#2
Gonzalo A Bravo-Soto, Trinidad Madrid
The number of patients requiring renal replacement therapy has increased exponentially in recent years. However, there is still controversy regarding the best moment to initiate chronic dialysis. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews comprising 21 trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded delaying the initiation of dialysis probably does not increase mortality risk in chronic kidney disease and makes little or no difference in the risk of requiring a temporary catheter or having to check the vascular access...
November 15, 2016: Medwave
https://www.readbyqxmd.com/read/27473868/guidewire-exchange-vs-new-site-placement-for-temporary-dialysis-catheter-insertion-in-icu-patients-is-there-a-greater-risk-of-colonization-or-dysfunction
#3
Elisabeth Coupez, Jean-François Timsit, Stéphane Ruckly, Carole Schwebel, Didier Gruson, Emmanuel Canet, Kada Klouche, Laurent Argaud, Julien Bohe, Maïté Garrouste-Orgeas, Christophe Mariat, François Vincent, Sophie Cayot, Olivier Cointault, Alain Lepape, Michael Darmon, Alexandre Boyer, Elie Azoulay, Lila Bouadma, Alexandre Lautrette, Bertrand Souweine
BACKGROUND: Intensive care unit (ICU) patients require dialysis catheters (DCs) for renal replacement therapy (RRT). They carry a high risk of developing end-stage renal disease, and therefore their vascular access must be preserved. Guidewire exchange (GWE) is often used to avoid venipuncture insertion (VPI) at a new site. However, the impact of GWE on infection and dysfunction of DCs in the ICU is unknown. Our aim was to compare the effect of GWE and VPI on DC colonization and dysfunction in ICU patients...
July 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27462389/umbilical-hernia-in-patients-with-liver-cirrhosis-a-surgical-challenge
#4
REVIEW
Julio C U Coelho, Christiano M P Claus, Antonio C L Campos, Marco A R Costa, Caroline Blum
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites...
July 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27312761/outpatient-removal-of-tunneled-dialysis-catheters-by-nephrology-fellows-in-training-at-a-veterans-affairs-medical-center
#5
Neville R Dossabhoy, Bhupinder Sangha, Mihály B Tapolyai, Tibor Fülöp
BACKGROUND: Removal of tunneled dialysis catheters (TDC) usually occurs in dedicated procedure suites and is performed relatively rarely at the bedside. Scarce evidence exists in the literature to assess the safety and success of this procedure when performed during supervised academic training. PATIENTS AND METHODS: We conducted a retrospective chart review of all TDC removals performed on an outpatient basis by nephrology fellows under faculty supervision during a 5-year period at an academic Veterans Affairs Medical Center...
July 12, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27290017/guidewire-exchange-vs-new-site-placement-for-temporary-dialysis-catheters-insertion-in-icu-patients-is-there-a-greater-risk-of-colonization-or-dysfunction
#6
E Coupez, J-F Timsit, A Boyer, L Bouadma, E Canet, K Klouche, L Argaud, J Bohé, M Garrouste-Orgeas, C Mariat, F Vincent, S Cayot, O Cointault, A Lepape, M Darmon, S Ruckly, C Schwebel, A Lautrette, B Souweine
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27215252/a-study-of-outcome-and-complications-associated-with-temporary-hemodialysis-catheters-in-a-nigerian-dialysis-unit
#7
Christiana Oluwatoyin Amira, Babawale Taslim Bello, Rotimi Williams Braimoh
Hemodialysis (HD) catheters are commonly used as temporary vascular access in patients with kidney failure who require immediate HD. The use of these catheters is limited by complications such as infections, thrombosis resulting in poor blood flow. We studied the complications and outcomes of nontunneled catheters used for vascular access in our dialysis unit. The records of all patients, with renal failure who were dialyzed over a two-year period and had a double lumen nontunneled catheter inserted, were retrieved...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27151579/stent-graft-repair-of-iatrogenic-femoral-arteriovenous-fistula-with-acute-bleeding-after-hemodialysis-catheter-insertion
#8
Chih-Hsien Lee
An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein. Double-lumen catheters are widely used for gaining temporary access in patients requiring acute hemodialysis (HD). Several complications are associated with the insertion of these catheters, including bleeding, infection, arterial injuries, and deep venous thrombosis. An iatrogenic AVF is a rare and severe complication following catheterization for temporary HD. Here, we report the case of a patient who developed an iatrogenic AVF following catheterization for acute HD resulting in acute bleeding...
May 5, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27113506/renal-ultrasound-dialysis-catheter-placement-and-kidney-biopsy-experience-of-us-nephrology-fellows
#9
Mala Sachdeva, Daniel W Ross, Hitesh H Shah
Procedures are a key component to the practice of nephrology. The Accreditation Council for Graduate Medical Education (ACGME) requires nephrology fellows to acquire skills and demonstrate competency in the performance of several procedures during fellowship training, including temporary hemodialysis catheter placement, biopsy of native and transplanted kidneys, and various dialytic therapies. It is also required that fellows acquire competency in the interpretation of renal imaging, including renal ultrasound, during their training...
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27020172/complications-of-permanent-hemodialysis-catheter-placement-need-for-better-pre-implantation-algorithm
#10
Vedran Premuzic, Ranko Smiljanic, Drazen Perkov, Bruna Brunetta Gavranic, Boris Tomasevic, Bojan Jelakovic
There is a correlation between central venous cannulation and the development of central venous stenosis. Minor retrosternal vein lesions can be easily missed. Computerized tomographic (CT) venography is the diagnostic procedure of choice. The aim of this study was to examine the complications after catheter implantation in patients with prior permanent catheter placement and to evaluate present diagnostic procedures performed prior to choosing permanent access site in order to reduce possible complications after catheter placement...
August 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/26920700/geographic-and-facility-variation-in-initial-use-of-non-tunneled-catheters-for-incident-maintenance-hemodialysis-patients
#11
Edward G Clark, Ayub Akbari, Brett Hiebert, Swapnil Hiremath, Paul Komenda, Charmaine E Lok, Louise M Moist, Michael E Schachter, Navdeep Tangri, Manish M Sood
BACKGROUND: Non-tunneled (temporary) hemodialysis catheters (NTHCs) are the least-optimal initial vascular access for incident maintenance hemodialysis patients yet little is known about factors associated with NTHC use in this context. We sought to determine factors associated with NTHC use and examine regional and facility-level variation in NTHC use for incident maintenance hemodialysis patients. METHODS: We analyzed registry data collected between January 2001 and December 2010 from 61 dialysis facilities within 12 geographic regions in Canada...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/26702001/unplanned-start-on-peritoneal-dialysis-right-after-pd-catheter-implantation-for-older-people-with-end-stage-renal-disease
#12
REVIEW
Johan V Povlsen, Anette Bagger Sørensen, Per Ivarsen
Unplanned start on dialysis remains a major problem for the dialysis community worldwide. Late-referred patients with end-stage renal disease (ESRD) and urgent need for dialysis are overrepresented among older people. These patients are particularly likely to be started on in-center hemodialysis (HD), with a temporary vascular access known to be associated with excess mortality and increased risks of potentially lethal complications such as bacteremia and central venous thrombosis or stenosis.The present paper describes in detail our program for unplanned start on automated peritoneal dialysis (APD) right after PD catheter implantation and summarizes our experiences with the program so far...
November 2015: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/26692024/chronic-haemodialysis-in-small-children-a-retrospective-study-of-the-italian-pediatric-dialysis-registry
#13
Fabio Paglialonga, Silvia Consolo, Carmine Pecoraro, Enrico Vidal, Bruno Gianoglio, Flora Puteo, Stefano Picca, Maria Teresa Saravo, Alberto Edefonti, Enrico Verrina
BACKGROUND: Chronic haemodialysis (HD) in small children has not been adequately investigated. METHODS: This was a retrospective investigation of the use of chronic HD in 21 children aged  <2 years (n = 12 aged <1 year) who were registered in the Italian Pediatric Dialysis Registry. Data collected over a period of >10 years were analysed. RESULTS: The median age of the 21 children at start of HD was 11.4 [interquartile range (IQR) 6...
May 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/26557553/analysis-of-vascular-access-in-haemodialysis-patients-single-center-experience
#14
R Hemachandar
BACKGROUND: Vascular access is the key in successful management of chronic haemodialysis (HD) patients. Though native arteriovenous fistula (AVF) is considered the access of choice, many patients in our country initiate haemodialysis through central venous catheter (CVC). There is paucity of data on vascular access in haemodialysis patients from southern India. AIM: Aim of the present study was to review our experience of vascular access in Haemodialysis patients (both central venous catheters and arteriovenous fistula) and to assess its success rate and common complications...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26448032/femoral-arteriovenous-fistula-associated-with-leg-swelling-6-months-after-removal-of-a-hemodialysis-catheter-a-case-report
#15
Lie Jin, Jian Wang, Chuifen Wu, Chuxiao Shao, Xueping Yu, Wenhui Lei
Double-lumen catheters have been used widely to obtain temporary access in patients who are in need of acute hemodialysis (HD) because of acute renal failure. Several complications are associated with the insertion of these catheters, including bleeding, infection, injuries to arteries, and deep venous thrombosis. An arteriovenous fistula (AVF) is a rare but significant complication following catheterization for temporary HD. Herein, we present a case of AVF associated with leg swelling 6 months after the removal ofa double-lumen HD catheter...
October 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26354590/a-cross-sectional-study-of-dialysis-practice-patterns-in-patients-with-chronic-kidney-disease-on-maintenance-hemodialysis
#16
Manjunath Jeevanna Kulkarni, Tukaram Jamale, Niwrutti K Hase, Pradeep Kiggal Jagdish, Vaibhav Keskar, Harsha Patil, Abhijeet Shete, Chetan Patil
We studied the dialysis practice-patterns with regard to various aspects of chronic kidney disease (CKD) stage 5D, like anemia, mineral bone disease, vaccination, hospitalization, hypertension and cost of therapy. Four hundred and sixty-four adult hemodialysis (HD) patients from various dialysis centers of Mumbai were included in the study. The mean age of the study patients was 47.2 years. Temporary dialysis catheters were the most common initial vascular access. Thirteen percent of prevalent HD patients were on temporary catheters; 33% of patients had history of failure of arterio-venous fistula...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/26349886/vascular-access-in-super-aged-patients
#17
COMPARATIVE STUDY
Hideki Kawanishi, Sadanori Shintaku, Misaki Moriishi
PURPOSE: In developed countries, dialysis patients are aging along with the general population. The choice of vascular access (VA) is a more complex decision among elderly patients and is not specifically addressed by clinical practice guidelines. We investigated the relationship between the VA type at dialysis initiation in elderly patients and their prognosis, as well as the selection of the optimal VA type. METHODS: We conducted a retrospective observational cohort study of consecutive adult patients (age ≥18 years) as their first form of renal replacement therapy (RRT) between January 1, 2003, and December 31, 2010...
November 2015: Journal of Vascular Access
https://www.readbyqxmd.com/read/26253036/cardiac-implantable-electronic-device-infection-in-patients-with-end-stage-renal-disease
#18
Avirup Guha, William R Maddox, Rhonda Colombo, N Stanley Nahman, Kristina W Kintziger, Jennifer L Waller, Matthew Diamond, Michele Murphy, Mufaddal Kheda, Sheldon E Litwin, Robert A Sorrentino
INTRODUCTION: Cardiac implantable electronic devices (CIED) are increasingly being used in end-stage renal disease (ESRD) patients. These patients have a high risk of device infection. OBJECTIVES: To study the optimal management of device infections in patients with ESRD. METHOD: We used the United States Renal Data System (USRDS) to assess the presence of a CIED and associated comorbidities, risk factors for infection, and mortality following device extraction or medical management in ESRD patients with CIED infection...
December 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/26238945/the-first-fistula-influence-of-location-on-catheter-use-and-the-influence-of-catheter-use-on-maturation
#19
Charles J Diskin, Thomas J Stokes, Linda M Dansby, Lautrec Radcliff, Thomas B Carter, Allen Lazenby
BACKGROUND: The forearm location for the initial vascular access has traditionally been considered the most desirable; however, recent advances in our understanding the physiology of fistula development suggest that the larger proximal vessels with higher blood flows may be associated with increased wall stress and faster fistula development. We examined whether the location of a first fistula had any relationship to the incidence and duration of catheter use. METHODS: This was an observational study of 808 patients who underwent the creation of an autologous arteriovenous fistula for their first hemodialysis access who were evaluated for the length of use of a temporary catheter...
September 2015: International Urology and Nephrology
https://www.readbyqxmd.com/read/26060370/successful-catheter-reinsertion-in-a-case-of-paecilomyces-varioti-peritonitis-in-a-patient-on-continuous-ambulatory-peritoneal-dialysis
#20
S B Mandarapu, K K Mukku, S B Raju, S Chandragiri
Peritonitis is one of the most common and important complications in patients on continuous ambulatory peritoneal dialysis (CAPD). Fungal peritonitis isreported in 4-8% of peritonitis episodes. Fungal peritonitis due to Paecilomyces species is not common. We report a case of CAPD peritonitis due to P. varioti. We immediately removed the CAPD catheter and IV amphotericin was administered for 4 weeks along with temporary hemodialytic support followed by successful catheter reinsertion.
May 2015: Indian Journal of Nephrology
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