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https://www.readbyqxmd.com/read/29615350/a-technique-for-the-salvage-of-megafistulas-allowing-immediate-dialysis-access
#1
Nosratollah Nezakatgoo, Steven D Kozusko, Jefferson T Watson, Rebecca Empting, Charles P Shahan, Michael J Rohrer
OBJECTIVE: Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation of the AVF, resulting in the development of a megafistula, is a complication that can result in a need for AVF revision and subsequent failure. METHODS: The charts of patients who underwent autogenous AVF revision because of the development of a megafistula with aneurysmectomy and vein transposition by a single surgeon during a 7-year period from 2009 through 2016 were reviewed...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29512407/the-association-of-genotype-polymorphisms-with-vascular-access-patency-in-hemodialysis-patients
#2
Chun-Fan Chen, Chih-Ching Lin
Some hemodialysis patients suffer from repeat dysfunction of dialysis vascular access and need procedures of angioplasty, thrombectomy, and even temporary catheter use. Why these patients are vulnerable to vascular access dysfunction and how to improve its patency are imperative to be discovered. Traditional risk factors for vascular access function had been widely investigated but could not fully explain this question. Several genotype polymorphisms were demonstrated to increase the incidence of cardiovascular disease and might also be linked to higher risk of vascular access dysfunction...
February 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29471458/pro-the-rationale-for-dietary-therapy-for-patients-with-advanced-chronic-kidney-disease
#3
Joel D Kopple, Denis Fouque
Dietary treatment offers many benefits to patients with advanced chronic kidney disease (CKD) who are approaching the need for renal replacement therapy. A large number of these benefits are independent of whether diets slow the rate of progression of CKD. These diets are low in protein and many minerals, and provide adequate energy for the CKD patient. The diets can reduce accumulation of potentially toxic metabolic products derived from protein and amino acid degradation, maintain a healthier balance of body water, sodium, potassium, phosphorus, calcium and other minerals, and prevent or improve protein-energy wasting...
March 1, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29458366/inequity-in-dialysis-related-practices-and-outcomes-in-aotearoa-new-zealand-a-kaupapa-m%C3%A4-ori-analysis
#4
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29456217/vascular-access-mortality-and-hospitalization-among-hemodialysis-patients-in-palestine
#5
Sondus A Hamadneh, Saja A Nueirat, Jamal Qadoomi', Mohammed Shurrab, Wajeh Y Qunibi, Zakaria Hamdan
Vascular access complications are common in patients with end-stage kidney disease who are receiving maintenance hemodialysis (HD) and are responsible for an enormous burden of morbidity and mortality among these patients. Differences in the all-cause mortality rate and hospitalization between dialysis catheter use and arteriovenous (AV) vascular access use have not been documented in our HD population. We performed a 12-month prospective analysis of our HD patients from four dialysis centers. We examined all-cause mortality and hospitalization in patients being dialyzed through HD catheters as compared to patients with AV access...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29399534/hemodialysis-access-thrombosis
#6
REVIEW
Keith Bertram Quencer, Rahmi Oklu
For the over 400,000 patients in the United States dependent on hemodialysis, arteriovenous (AV) access thrombosis may lead to missed dialysis sessions, inpatient admissions and the need for placement of temporary dialysis catheters. It is also the leading cause of permanent access loss. Percutaneous declotting is generally preferred over surgical thrombectomy. Various percutaneous approaches can be employed including the lyse-and-wait technique, thromboaspiration, pulse spray aided pharmacomechanical thrombolysis, and use of mechanical thrombectomy device...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29383761/reducing-intra-abdominal-pressure-in-peritoneal-dialysis-patients-to-avoid-transient-hemodialysis
#7
EDITORIAL
Januvi Jegatheswaran, Jeffrey Warren, Deborah Zimmerman
Patients treated with peritoneal dialysis (PD) are often required to switch to hemodialysis (HD) temporarily when they develop abdominal wall hernias and dialysate leaks, peritonitis or undergo thoracic or abdominal surgeries. There are significant risks associated with incident hemodialysis including possible central venous catheter infections, thrombosis, and need for invasive procedures. Therefore, strategies to avoid temporary transfer to hemodialysis are desirable. The increased intra-abdominal pressure associated with PD is largely responsible for the issues requiring withholding PD...
January 30, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29228920/comparison-of-outcomes-between-emergent-start-and-planned-start-peritoneal-dialysis-in-incident-esrd-patients-a-prospective-observational-study
#8
Wen-Yi Li, Yi-Cheng Wang, Shang-Jyh Hwang, Shih-Hua Lin, Kwan-Dun Wu, Yung-Ming Chen
BACKGROUND: The clinical consequences of starting chronic peritoneal dialysis (PD) after emergent dialysis via a temporary hemodialysis (HD) catheter has rarely been evaluated within a full spectrum of treated end-stage renal disease (ESRD). We investigated the longer-term outcomes of patients undergoing emergent-start PD in comparison with that of other practices of PD or HD in a prospective cohort of new-onset ESRD. METHODS: This was a 2-year prospective observational study...
December 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29192722/cephalic-vein-transposition-is-a-durable-approach-to-managing-cephalic-arch-stenosis
#9
Jon C Henry, Ulka Sachdev, Eric Hager, Ellen Dillavou, Theodore Yuo, Michel Makaroun, Steven A Leers
INTRODUCTION: The proximal cephalic vein that enters the axillary vein (cephalic arch) is a common site of stenosis in patients with upper extremity arteriovenous fistulas for hemodialysis (HD). In this study, we present the outcomes of a series of cephalic vein transposition, to determine its utility in the setting of refractory arch stenosis. METHODS: We conducted a retrospective review of patients undergoing cephalic vein transposition to manage refractory cephalic arch stenosis from January 1, 2008 to August 31, 2015...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#10
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
December 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#11
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29123006/outcomes-of-simultaneous-peritoneal-dialysis-and-arteriovenous-fistula-placement-in-end-stage-renal-disease-patients
#12
Nosratollah Nezakatgoo, Albert Ndzengue, Manhunath Ramaiah, Elvira O Gosmanova
Peritoneal dialysis (PD) interruption requiring hemodialysis (HD) is not uncommon and its frequently abrupt nature prevents timely creation of permanent HD access and avoidance of central venous catheters (CVC). We retrospectively studied a cohort of 24 end-stage renal disease (ESRD) patients (mean age 50.7 years, 83.3% African-Americans, 58.3% females, time on dialysis interquartile range [IQR] 0 - 65 days) who had simultaneous PD catheter insertion and backup arteriovenous fistula (AVF) creation between January 1, 2012, and December 31, 2013...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29112475/transjugular-venous-approach-for-endovascular-interventions-in-hemodialysis-grafts-and-fistulas-of-the-upper-extremities
#13
Hector Ferral, Marc J Alonzo
OBJECTIVE: This article describes the use of a transjugular venous access for interventions in upper extremity hemodialysis arteriovenous fistulas (AVFs) and grafts. This access is used in selected patients in whom direct puncture of the hemodialysis access is considered to be difficult or cumbersome. Technical success was achieved in 96.7% of patients. If an intervention is unsuccessful, the transjugular access offers the possibility of placement of a dialysis catheter for temporary or long-term hemodialysis...
February 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29064173/evaluation-of-the-functions-of-the-temporary-catheter-with-various-tip-types
#14
Tomonari Ogawa, Yusuke Sasaki, Yuki Kanayama, Kunihiko Yasuda, Yoshimi Okada, Yuta Kogure, Tatsuro Sano, Minoru Hatano, Hiroaki Hara, Koichi Kanozawa, Hajime Hasegawa
INTRODUCTION: A temporary catheter (TC) is used short-term and for emergencies. There are some cases when we cannot withdraw blood immediately after inserting the catheter in our patients. The reason is said to be the tips of the TC sticking to the vascular walls. OBJECTIVE: We evaluated examined 3 catheters with different tip shapes in a simulation circuit to assess the effect on the blood flow. METHODS: Water was circulated in the simulation circuit at 1 L/minute...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29017700/switching-temporary-hemodialysis-catheters-to-long-term-catheters-exchange-versus-de-novo-placement-any-difference-in-line-infection
#15
Maen Aboul Hosn, Zeina Nasser, Elias Elias, Walid Medawar, Majida Daouk, Jamal Hoballah, Fady Haddad
BACKGROUND: Shifting from a short-term catheter to a long-term one is done either by removing the old catheter and placing a new long-term one via fresh new puncture site, or by replacing the old catheter with a long-term one over a guidewire. AIM: We aimed to describe our technique in changing a temporary line to a long-term catheter (LTC) over a guidewire and to determine the incidence of line-related infections following this procedure. MATERIALS AND METHODS: A retrospective pilot study was conducted between 2005 and 2010 at the American University of Beirut Hospital...
November 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28937077/practice-pattern-of-hemodialysis-among-end-stage-renal-disease-patients-in-rural-south-india-a-single-center-experience
#16
R Hemachandar
Hemodialysis (HD) is the most common mode of renal replacement therapy for end-stage renal disease (ESRD) patients in India. However, the practice and pattern of dialysis in a hospital serving rural population is largely unknown. A prospective study of 127 ESRD patients initiated on HD between January 2013 and December 2014 was done. The study included 101 males and 26 females, with a mean age of 50.05 ± 13.80 years. Native kidney disease was unknown in 45.67% of patients as they presented very late in their disease course...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#17
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28887265/modified-staple-aneurysmorrhaphy-for-treating-arteriovenous-fistula-related-venous-aneurysms
#18
Robert Moskowitz, Elias Fakhoury, Kevin V James
Autogenous arteriovenous fistulas (AVFs) 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 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28779788/transjugular-venous-approach-for-endovascular-intervention-in-upper-extremity-dialysis-access-fistulae-and-grafts
#19
REVIEW
Hector Ferral, Marc J Alonzo
A transjugular venous access is an alternative approach for endovascular intervention in upper-extremity dialysis arteriovenous fistulae and grafts. The transjugular access is recommended for patients who have an unfavorable anatomy for the direct arm access approach. Ultrasound evaluation of the arteriovenous access is essential before intervention and includes evaluation of the inflow artery and outflow vein diameters, arteriovenous anastomosis, and the entire outflow vein, specifically looking into potential problem areas...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28639916/benefits-of-long-versus-short-thrombolysis-times-for-acutely-thrombosed-hemodialysis-native-fistulas
#20
COMPARATIVE STUDY
Susanne Regus, Werner Lang, Marco Heinz, Michael Uder, Axel Schmid
INTRODUCTION: Local thrombolysis with a time of exposure to recombinant tissue plasminogen activator of 15 to 150 minutes is commonly used to declot acutely thrombosed hemodialysis fistulas. The duration of thrombolysis for the restoration of arteriovenous blood flow remains controversial. The aim of this study was to investigate the outcomes of long thrombolysis treatment (LTT, 3 hours or more) and short thrombolysis treatment (STT, less than 3 hours) in our institution. METHODS: We retrospectively analyzed 86 interventional declotting procedures (28 STT and 58 LTT) applied to 86 acutely thrombosed hemodialysis fistulas...
July 2017: Vascular and Endovascular Surgery
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