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vascular access AKI PATIENTS

Dhaval Kolte, Nathan Spence, Mohamedtauqir Puthawala, Omar Hyder, Christopher P Tuohy, Carolyn B Davidson, Mark W Sheldon, Warren K Laskey, J Dawn Abbott
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are at an increased risk of developing contrast-induced acute kidney injury (CI-AKI). Data on the association between transradial (TRA) vs. transfemoral (TFA) access and the risk of CI-AKI in this setting are limited. METHODS: We analyzed data on 1162 patients undergoing primary PCI for STEMI at two tertiary care centers between 2010 and 2014...
July 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Alexandru Rocşoreanu, Daniela Cernea, Cristiana Eugenia Simionescu, Eugen MoŢa
Bleeding disorders, associated with macroscopic and microscopic lesions in different organs are frequently found in acute kidney injury (AKI), in the third stage of the RIFLE (risk, injury, failure, loss, end-stage kidney disease) classification, treated by hemodialysis. The study included 81 cases of AKI of various causes (septic, posttraumatic, postoperative, toxic, medical nephropathies). 59.25% of the patients presented various forms of bleeding disorders (gastrointestinal bleeding, meningo-cerebral hemorrhage, epistaxis, hemodialysis vascular access bleeding, etc...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Giuseppe Andò, Francesco Costa, Olimpia Trio, Giuseppe Oreto, Marco Valgimigli
OBJECTIVES: We performed a systematic review of the literature and a meta-analysis to examine the role of access site in affecting the incidence of acute kidney injury (AKI) after percutaneous coronary intervention (PCI). BACKGROUND: The vascular access site may play a central role among procedure-related risk factors for AKI after PCI. Transradial access is associated with reduced vascular complications and major bleeding which, in turn, is an emerging risk factor for post-procedural AKI...
July 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Frances Fothergill Bourbonnais, Sharon Slivar, Sue Malone Tucker
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients. Renal replacement therapy is prescribed for as many as 70% of critically ill patients in AKI and may be provided in the form of intermittent or continuous dialysis including intermittent hemodialysis, sustained low-efficiency dialysis, and continuous renal replacement therapy (CR RT). CRRT is commonly used for unstable critically ill patients, as it involves a slow continuous process. The nursing work involved with CR RT is highly complex and the learning requirements are challenging; therefore, it is important to identify nursing practices...
2016: Canadian Journal of Critical Care Nursing
Giuseppe Andò, Bernardo Cortese, Enrico Frigoli, Andrea Gagnor, Stefano Garducci, Carlo Briguori, Paolo Rubartelli, Paolo Calabrò, Marco Valgimigli
Acute kidney injury (AKI) is an important complication of both diagnostic cardiac catheterization and percutaneous coronary intervention (PCI). A large body of evidence supports that AKI is related to volume of contrast used. Despite several measures are available to reduce the impact of contrast media on AKI, its incidence remains significant as other mechanisms of renal damage are involved. A new paradigm is established according to which bleeding prevention is at least as important as preventing recurrent ischemic events in the management of patients with acute coronary syndromes (ACS) undergoing an invasive approach...
November 2015: Catheterization and Cardiovascular Interventions
Marc Najjar, Michael Salna, Isaac George
The occurrence of acute kidney injury (AKI) following aortic valve replacement (AVR) has very serious clinical implications and has therefore been the focus of several studies. The authors report the results of previous studies evaluating both transcatheter AVR (TAVR) and indirectly surgical AVR (SAVR) through looking at cardiopulmonary bypass (CPB) cardiac surgeries, and identify the incidence, predictors and outcomes of AKI following AVR. In most studies, AKI was defined using the Risk, Injury, Failure, Loss and End Stage, Valve Academic Research Consortium (modified Risk, Injury, Failure, Loss and End Stage) or Valve Academic Research Consortium-2 (Acute Kidney Injury Network) AKI classification criteria...
March 2015: Expert Review of Cardiovascular Therapy
Ahmed A Al-Jaishi, Charmaine E Lok, Amit X Garg, Joyce C Zhang, Louise M Moist
BACKGROUND AND OBJECTIVES: In Canada, approximately 17% of patients use an arteriovenous access (fistula or arteriovenous graft) at commencement of hemodialysis, despite guideline recommendations promoting its timely creation and use. It is unclear if this low pattern of use is attributable to the lack of surgical creation or a high nonuse rate. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using large health care databases in Ontario, Canada, a population-based cohort of adult patients (≥18 years old) who initiated hemodialysis as their first form of RRT between 2001 and 2010 was studied...
March 6, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Anja Gutmann, Klaus Kaier, Stefan Sorg, Constantin von Zur Mühlen, Matthias Siepe, Martin Moser, Annette Geibel, Andreas Zirlik, Ingo Ahrens, Hardy Baumbach, Friedhelm Beyersdorf, Werner Vach, Manfred Zehender, Christoph Bode, Jochen Reinöhl
BACKGROUND: This study aims at analyzing complication-induced additional costs of patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: In a prospective observational study, a total of 163 consecutive patients received either transfemoral (TF-, n=97) or transapical (TA-) TAVR (n=66) between February 2009 and December 2012. Clinical endpoints were categorized according to VARC-2 definitions and in-hospital costs were determined from the hospital perspective...
January 20, 2015: International Journal of Cardiology
Rémi Bruyère, Agnès Soudry-Faure, Gilles Capellier, Christine Binquet, Abdelouaid Nadji, Stephane Torner, Gilles Blasco, Maria Yannaraki, Saber Davide Barbar, Jean-Pierre Quenot
BACKGROUND: The incidence of acute kidney injury (AKI) is estimated at 10 to 20% in patients admitted to intensive care units (ICU) and often requires renal replacement therapy (RRT). ICU mortality in AKI patients can exceed 50%. Venous catheters are the preferred vascular access method for AKI patients requiring RRT, but carry a risk of catheter thrombosis or infection. Catheter lock solutions are commonly used to prevent such complications. Heparin and citrate locks are both widely used for tunneled, long-term catheters, but few studies have compared citrate versus heparin for patients with short-term, non-tunneled catheters...
2014: Trials
Bernardo Cortese, Alessandro Sciahbasi, Rodrigo Sebik, Stefano Rigattieri, Alessandro Alonzo, Pedro Silva-Orrego, Flavia Belloni, Romano G Seregni, Francesca Giovannelli, Maurizio Tespili, Roberto Ricci, Andrea Berni
The risk of acute kidney injury (AKI) is a major issue after percutaneous coronary interventions (PCIs), especially in the setting of ST-elevation myocardial infarction. Preliminary data from large retrospective registries seem to show a reduction of AKI when a transradial (TR) approach for PCI is adopted. Little is known about the relation between vascular access and AKI after emergent PCI. We here report the results of the Primary PCI from Tevere to Navigli (PRIPITENA), a retrospective database of primary PCI performed at high-volume centers in the urban areas of Rome and Milan...
September 15, 2014: American Journal of Cardiology
Judith Kooiman, Milan Seth, Simon Dixon, David Wohns, Thomas LaLonde, Sunil V Rao, Hitinder S Gurm
BACKGROUND: Transradial percutaneous coronary intervention (PCI [TRI]) does not involve catheter manipulation in the descending aorta, whereas transfemoral PCI (TFI) does. Therefore, the risk of acute kidney injury (AKI) after PCI might be influenced by vascular access site. We compared risks of AKI and nephropathy requiring dialysis (NRD) among patients treated with TRI and TFI. METHODS AND RESULTS: We included patients across 47 hospitals in Michigan. Primary end point was AKI (serum creatinine increase ≥0...
April 2014: Circulation. Cardiovascular Interventions
Yacine Elhmidi, Sabine Bleiziffer, Marcus-André Deutsch, Markus Krane, Domenico Mazzitelli, Rüdiger Lange, Nicolo Piazza
There is a paucity of data describing acute kidney injury (AKI) following transcatheter aortic valve implantation and its impact on mortality remains unknown. We therefore evaluate the incidence, predictors and impact of AKI following transcatheter aortic valve implantation. We searched MEDLINE for studies from 2008 to 2013, evaluating AKI after transcatheter aortic valve implantation. All studies were compared according to the incidence, predictors and impact of AKI following transcatheter aortic valve implantation...
February 2014: Archives of Cardiovascular Diseases
Kamal El Masri, Kimberly Jackson, Santiago Borasino, Mark Law, David Askenazi, Jeffrey Alten
BACKGROUND: Acute kidney injury (AKI) frequently occurs in neonates and infants after cardiopulmonary bypass (CPB) and may require renal replacement therapy (RRT). Peritoneal dialysis (PD) is the RRT modality of choice in neonates with AKI after CPB, but continuous renal replacement therapy (CRRT) may be necessary if PD is ineffective or contraindicated. Vascular access is challenging in this population, in part, due to small central vein size that may preclude placement. The risk of malfunction or morbidity associated with standard dialysis catheters may be excessive in neonates with congenital heart disease...
December 2013: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Melvin Bonilla-Félix
Acute kidney injury (AKI) is a common complication in pediatric and neonatal intensive care units (ICU). Renal replacement therapy (RRT) is frequently needed in children in whom supportive therapy is not enough to satisfy their metabolic demands or to be able to provide adequate nutrition. The decision to begin dialysis should not be delayed since experience in infants shows that the shorter the time from the insult to the beginning of dialysis, the higher the survival rate. As the use of continuous RRT in pediatric patients in the ICU has almost tripled, the use of peritoneal dialysis (PD) and intermittent hemodialysis has markedly decreased...
2013: Blood Purification
Natacha Mrozek, Alexandre Lautrette, Jean-François Timsit, Bertrand Souweine
Acute kidney insufficiency (AKI) occurs frequently in intensive care units (ICU). In the management of vascular access for renal replacement therapy (RRT), several factors need to be taken into consideration to achieve an optimal RRT dose and to limit complications. In the medium and long term, some individuals may become chronic dialysis patients and so preserving the vascular network is of major importance. Few studies have focused on the use of dialysis catheters (DC) in ICUs, and clinical practice is driven by the knowledge and management of long-term dialysis catheter in chronic dialysis patients and of central venous catheter in ICU patients...
2012: Annals of Intensive Care
Daniela Ponce, André Luís Balbi, Richard Amerling
Peritoneal dialysis (PD) is a simple, safe, cheap, and efficient renal replacement therapy method. It can correct metabolic disorders and fluid overload in acute kidney injury (AKI) patients both in and out of the intensive care unit. Use of PD in AKI is enhanced by placement of a Tenckhoff catheter, which can be safely accomplished at the bedside. Some PD modalities, such as high-volume PD and continuous-flow PD, can provide dialysis doses and efficiency comparable to extracorporeal blood purification methods...
2012: Blood Purification
Ami M Patel, Gbemisola A Adeseun, Irfan Ahmed, Nanhi Mitter, J Eduardo Rame, Michael R Rudnick
Implantable left ventricular assist devices (LVADs) are increasingly being used as a bridge to transplantation or as destination therapy in patients with end stage heart failure refractory to conventional medical therapy. A significant number of these patients have associated renal dysfunction before LVAD implantation, which may improve after LVAD placement due to enhanced perfusion. Other patients develop AKI after implantation. LVAD recipients who develop AKI requiring renal replacement therapy in the hospital or who ultimately require long-term outpatient hemodialysis therapy present management challenges with respect to hemodynamics, volume, and dialysis access...
March 2013: Clinical Journal of the American Society of Nephrology: CJASN
Patrick M Honoré, Rita Jacobs, Olivier Joannes-Boyau, Willem Boer, Eisabeth De Waele, Jouke De Regt, Herbert D Spapen
Haemodialysis (HD) is a well-established, longstanding, and life-saving treatment for patients with chronic kidney disease (CKD) or acute kidney injury (AKI). However, side-effects of HD in CKD patients are numerous and remain problematic. Amongst others, CKD patients are susceptible to short-term effects caused by abnormalities in water and electrolyte balance and long-term effects related to sustained inflammation short-term side-effects of HD such as errors in sodium content of dialysate could readily be overcome by correct baseline labelling of dialysates and the ongoing rigorous implementation of safety procedures by staff nurses and physicians...
June 2012: International Journal of Artificial Organs
Guillermo Rosa-Diez, Gustavo Greloni, María Crucelegui, Mariela Bedini-Roca, Agustina Heredia-Martínez, M Luisa Coli, Sergio Giannasi, Eduardo San-Román, Rodolfo Pizarro, César Belzitti, Salomón Algranati, Ricardo Heguilen
BACKGROUND: Estimating the dialysis dose is a requirement commonly used to assess the quality of renal replacement therapy (RRT) in patients with chronic kidney disease (CKD). In patients with acute kidney injury (AKI), this value is not always evaluated and it has been estimated that the prescribed dose is seldom obtained. Reports addressing this issue in AKI individuals are scarce and most have not included an adequate number of patients or treatments, nor were patients treated with extended therapies...
May 14, 2012: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Emmanuel A Burdmann, Rajasekara Chakravarthi
Peritoneal dialysis (PD) is a simple, safe, gentle, and efficient renal replacement therapy (RRT) method. It is able to correct acute kidney injury (AKI)-induced metabolic, electrolytic, and acid-base disorders and volume overload both in and out the intensive care unit setting. Some PD modalities, such as high-volume PD and continuous flow PD, can provide RRT doses and efficiency comparable to extracorporeal blood purification methods. PD is particularly suitable for children, patients with refractory heart failure or hemodynamically instable, conditions where systemic anticoagulation should be avoided, patients with difficulty for vascular access and hypo- and hyperthermia conditions...
March 2011: Seminars in Dialysis
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