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Central venous catheter dialysis

Eric Pillado, Mina Behdad, Russell Williams, Samuel E Wilson
INTRODUCTION: Construction of radiocephalic AV fistula (RC- AVF) results in successful hemodialysis (HD) in approximately 40 percent of ESRD patients. We investigated whether RC-AVF flow measured by ultrasound 30 days postoperative predicted successful HD. METHODS: In this prospective study color Doppler ultrasound (DUS) was used to measure cephalic vein outflow volume at three forearm sites one and three months postoperative. RESULTS: Of 45 consecutive patients screened for feasibility of RC-AVF by physical exam and US arterial and vein mapping, 41 were considered suitable for construction of RC-AVF...
February 22, 2018: Annals of Vascular Surgery
Steven M Brunelli, David B Van Wyck, Levi Njord, Robert J Ziebol, Laurie E Lynch, Douglas P Killion
Central venous catheters (CVCs) contribute disproportionately to bloodstream infection (BSI) and, by extension, to infection-related hospitalization, mortality, and health care costs in patients undergoing dialysis. Recent product advancements may reduce BSIs, but a sufficiently powered comparative-effectiveness study is needed to facilitate evidence-based patient care decisions. In a 13-month, prospective, cluster-randomized, open-label trial, we compared BSI rates in facilities using ClearGuard HD antimicrobial barrier caps (ClearGuard group) with those in facilities using Tego hemodialysis connectors plus Curos disinfecting caps (Tego+Curos group)...
February 22, 2018: Journal of the American Society of Nephrology: JASN
Eleanor Murray, Mahmoud Eid, Jamie P Traynor, Karen S Stevenson, Ram Kasthuri, David B Kingsmore, Peter C Thomson
Background: The modality by which haemodialysis (HD) is delivered [arteriovenous fistula (AVF), arteriovenous graft (AVG) or central venous catheter (CVC)] varies widely and is influenced by clinical evidence, patient factors and the prevailing service configuration. The aim of this study was to determine the outcome and impact of access strategy on patient outcome by mapping out the HD journey in a cohort of incident patients. Methods: A 2-year cohort of consecutive incident HD patients from the point of referral for first dialysis access to completion of the first 365 days of HD was prospectively reviewed...
February 1, 2018: Nephrology, Dialysis, Transplantation
K Shivanand Nayak, Sreepada V Subhramanyam, Navva Pavankumar, Sinoj Antony, M A Sarfaraz Khan
BACKGROUND/AIMS: Initiating renal replacement therapy in late referred patients with central venous catheter (CVC) hemodialysis (HD) causes serious complications. In urgent start peritoneal dialysis, initiating peritoneal dialysis (PD) within 14 days of catheter insertion still needs HD with CVC. We initiated Emergent start PD (ESPD) with Automated PD (APD) at our center within 48 h from the time of presentation. METHODS: A prospective, case-controlled, intention-to-treat study with 56 patients was conducted between March 2016 and August 2017...
January 30, 2018: Blood Purification
Eric Pillado, Abraham Korn, Christian de Virgilio, Nina Bowens
Prolonged use of central venous catheters (CVCs) for hemodialysis (HD) is associated with greater morbidity and mortality when compared with autogenous arteriovenous fistulas (AVF). The objective was to assess compliance with CVC guidelines in adults referred for hemoaccess at a county teaching hospital. Out of 256 patients, 172 (67.2%) were male, with a mean age of 50.0 ± 12.4 years. Overall 62.5 per cent initiated dialysis via CVC. Patients were divided into two groups (those with CVC (62.5%) and those without (37...
October 1, 2017: American Surgeon
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
Ying Zhang, Xianglei Kong, Lijun Tang, Yong Wei, Dongmei Xu
Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit...
January 19, 2018: Therapeutic Apheresis and Dialysis
Mayra Gonçalves Menegueti, Natália Cristina Betoni, Fernando Bellissimo-Rodrigues, Elen Almeida Romão
INTRODUCTION: Bloodstream infections are the second most common cause of death among patients on hemodialysis. This study aimed to evaluate the incidence of and risk factors associated with central venous catheter-related infections in patients undergoing hemodialysis, and to identify and characterize the type and antimicrobial susceptibility profiles of the primary microorganisms isolated during one year of follow-up. METHODS: A prospective cohort study was conducted in 2014 in a hemodialysis referral center...
November 2017: Revista da Sociedade Brasileira de Medicina Tropical
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Ken J Park, Eric S Johnson, Ning Smith, David M Mosen, Micah L Thorp
CONTEXT: Central venous catheter (CVC) use is associated with increased mortality and complications in hemodialysis recipients. Although prevalent CVC use has decreased, incident use remains high. OBJECTIVE: To examine characteristics associated with CVC use at initial dialysis, specifically looking at proteinuria as a predictor of interest. DESIGN: Retrospective cohort of 918 hemodialysis recipients from Kaiser Permanente Northwest who started hemodialysis from January 1, 2004, to January 1, 2014...
2017: Permanente Journal
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
Camiel L M de Roij van Zuijdewijn, Isabelle Chapdelaine, Menso J Nubé, Peter J Blankestijn, Michiel L Bots, Constantijn J A M Konings, Ton K Kremer Hovinga, Femke M Molenaar, Neelke C van der Weerd, Muriel P C Grooteman
Background. Available evidence suggests a reduced mortality risk for patients treated with high-volume postdilution hemodiafiltration (HDF) when compared with hemodialysis (HD) patients. As the magnitude of the convection volume depends on treatment-related factors rather than patient-related characteristics, we prospectively investigated whether a high convection volume (defined as ≥22 L/session) is feasible in the majority of patients (>75%). Methods. A multicenter study was performed in adult prevalent dialysis patients...
December 2017: Clinical Kidney Journal
Steve Siu-Man Wong, Hau C Kwaan, Todd S Ing
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures...
December 2017: Clinical Kidney Journal
Stephanie Thompson, Natasha Wiebe, Scott Klarenbach, Rick Pelletier, Brenda R Hemmelgarn, John S Gill, Braden J Manns, Marcello Tonelli
BACKGROUND: For people requiring hemodialysis, infectious mortality is independently associated with geographic distance from a nephrologist. We aimed to determine if differential management of catheter-related blood stream infections (CRBSIs) could explain poorer outcomes. METHODS: We prospectively collected data from adults initiating hemodialysis with a central venous catheter between 2005 and 2015 in Alberta, Canada. We collected indicators of CRBSI management (timely catheter removal, relapsing bacteremia); frequency of CRBSIs; hospitalizations; predictors of CRBSIs, and bacteremia...
December 8, 2017: BMC Nephrology
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
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
Vassilios Liakopoulos, Stefanos Roumeliotis, Xenia Gorny, Evangelia Dounousi, Peter R Mertens
Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se...
2017: Oxidative Medicine and Cellular Longevity
Hiroshi Sekiguchi, Luke A Seaburg, Jun Suzuki, Walter J Astorne, Anil S Patel, A Scott Keller, Ognjen Gajic, Kianoush B Kashani
PURPOSE: To investigate correlation of central venous pressure (CVP) with ultrasonographic measurement of central veins, along with association between these variables and occurrence of intradialytic adverse events in hospitalized patients. MATERIALS AND METHODS: Patients requiring hemodialysis via dialysis catheter were prospectively enrolled. CVP measurements through catheter, internal jugular vein aspect ratio, subclavian vein collapsibility, inferior vena cava (IVC) maximal diameter, and IVC collapsibility were recorded before and after hemodialysis...
October 29, 2017: Journal of Critical Care
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
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
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