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Renal vascular access

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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/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#2
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28218363/sex-race-and-hemodialysis-vascular-access-processes
#3
Rita L McGill, Eduardo Lacson
PURPOSE: Hemodialysis (HD) patients who are female or black receive fewer arteriovenous fistulas (AVF) and more grafts (AVG). We evaluated race- and sex-based differences for three process exposures: access surgery, peripherally-inserted central catheters (PICCs), and vascular imaging. METHODS: US Renal Data System with linked Medicare claims for patients initiating HD between April 2010 - December 2011 were used to identify PICC placement, imaging, AVF and AVG surgeries, and the vascular accesses in use at individual HD treatments...
February 8, 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
#4
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
#5
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/28208170/optical-coherence-tomographic-angiography-in-type-2-diabetes-and-diabetic-retinopathy
#6
Daniel Shu Wei Ting, Gavin Siew Wei Tan, Rupesh Agrawal, Yasuo Yanagi, Nicole Ming Sie, Chee Wai Wong, Ian Yew San Yeo, Shu Yen Lee, Chui Ming Gemmy Cheung, Tien Yin Wong
Importance: Optical coherence tomographic angiography (OCT-A) is able to visualize retinal microvasculature without the need for injection of fluorescein contrast dye. Nevertheless, it is only able to capture a limited view of macula and does not show leakage. Objectives: To evaluate the retinal microvasculature using OCT-A in patients with type 2 diabetes as well as the association of OCT-A characteristics with diabetic retinopathy (DR) and systemic risk factors...
February 16, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28182039/hemodialysis-outcomes-and-practice-patterns-in-end-stage-renal-disease-experience-from-a-tertiary-care-hospital-in-kerala
#7
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/28165579/a-national-appraisal-of-haemodialysis-vascular-access-provision-in-scotland
#8
Scott W Oliver, Jacqueline Campbell, David B Kingsmore, Ram Kasthuri, Wendy Metcalfe, Jamie P Traynor, Denis Fischbacher-Smith, Alan G Jardine, Peter C Thomson
PURPOSE: Published registry data demonstrate longstanding variation in the utilisation of different vascular access (VA) modalities between Scottish renal units; this may reflect different clinical processes between centres. A comprehensive appraisal was undertaken to understand the processes underpinning VA creation and maintenance across Scotland. METHODS: A mixed methods approach was utilised. Fifty-two semi-structured interviews were conducted with patients and clinicians in all ten, adult and paediatric, Scottish renal units...
January 31, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28127180/cytoreductive-surgery-in-the-management-of-renal-tumours-rationale-current-evidence-and-future-perspectives
#9
Makarand V Khochikar
Renal cell carcinoma accounts for 3% of adult solid malignant tumours. Approximately 25% of the patients present with metastatic disease at presentation. In the era of immunotherapy (interferon alpha-2b and interleukin-2), studies showed significant survival benefit with cytoreductive nephrectomy (CRN) followed by interferon alpha-2b than interferon alpha 2-b alone. Introduction of targeted therapies (vascular endothelial growth factor receptor-tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors) in 2005 generated a great interest in the management of metastatic renal cell carcinoma (mRCC) as these drugs exhibited tumour shrinkage in the primary tumour as well as in the metastatic site/s...
March 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28110802/primary-prevention-of-sudden-cardiac-death-with-device-therapy-in-urban-and-rural-populations
#10
Ratika Parkash, Howard Wightman, Graham Miles, John L Sapp, Martin Gardner, Chris Gray, Brenda Brownell, Karen Giddens, Miroslaw Rajda
BACKGROUND: Implantable cardioverter defibrillators (ICDs) have shown benefit in reducing mortality in patients with heart failure, after myocardial infarction, and those with reduced ejection fraction. We sought to explore the use of this therapy in specialized heart function clinics, in rural and urban locations. METHODS: This was a retrospective cohort study performed in 3 specialized heart function clinics in Nova Scotia, 2 of which were in rural locations. All patients with an initial left ventricular ejection fraction ≤ 35% were included from 2006 to 2011...
January 7, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28110327/mortality-after-renal-allograft-failure-and-return-to-dialysis
#11
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/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#12
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#13
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28101117/maternal-mortality-ratio-and-causes-of-death-in-iri-between-2009-and-2012
#14
Marzieh Vahiddastjerdy, Nasrin Changizi, Abas Habibollahi, Leila Janani, Zahra Farahani, Farah Babaee
Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran. Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9) during pregnancy, labor, and 42 days after parturition...
September 2016: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/28100426/ferumoxytol-mra-for-transcatheter-aortic-valve-replacement-planning-with-renal-insufficiency
#15
Kimberly Kallianos, Travis S Henry, Yerem Yeghiazarians, Jeffrey Zimmet, Kendrick A Shunk, Elaine E Tseng, Vaikom Mahadevan, Michael D Hope
BACKGROUND: Computed tomography angiography (CTA) is the test of choice for pre-procedure imaging of transcatheter aortic valve replacement (TAVR) candidates. The iodinated contrast required, however, increases the risk of renal dysfunction in patients with pre-existing renal failure. Ferumoxytol is a magnetic resonance imaging (MRI) contrast agent that can be used with renal failure. Its long vascular resonance time allows gated MRA sequences that approach CTA in image quality. We present respiratory and cardiac gated MRA enabled by ferumoxytol that can be post-processed in an analogous fashion to CTA...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088437/safety-and-feasibility-of-pci-in-patients-undergoing-tavr-a-systematic-review-and-meta-analysis
#16
REVIEW
Anurag Bajaj, Samir Pancholy, Arjinder Sethi, Parul Rathor
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure...
January 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28067862/impact-of-indoxyl-sulfate-on-progenitor-cell-related-neovascularization-of-peripheral-arterial-disease-and-post-angioplasty-thrombosis-of-dialysis-vascular-access
#17
REVIEW
Chih-Cheng Wu, Szu-Chun Hung, Ko-Lin Kuo, Der-Cherng Tarng
Patients with chronic kidney disease (CKD) have an increased risk of vascular disease, which is associated with considerable health care costs. Vascular disease in CKD differs clinically and pathobiologically from that in patients with normal renal function. Besides the traditional risk factors, retention of uremic toxins contributes to the pathogenesis of vascular disease in patients with CKD. Indoxyl sulfate is a protein-bound uremic toxin and is inefficiently removed by conventional dialysis. Accumulating evidence suggests that indoxyl sulfate is a vascular toxin involved in atherosclerosis, arteriosclerosis, vascular calcification and vascular repair...
January 7, 2017: Toxins
https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#18
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28064159/prognostic-significance-of-pre-end-stage-renal-disease-serum-alkaline-phosphatase-for-post-end-stage-renal-disease-mortality-in-late-stage-chronic-kidney-disease-patients-transitioning-to-dialysis
#19
Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Yoshitsugu Obi, Connie M Rhee, Elani Streja, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Higher serum alkaline phosphatase (ALP) levels have been associated with excess mortality in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD). However, little is known about the impact of late-stage NDD-CKD ALP levels on outcomes after dialysis initiation. METHODS: Among 17 732 US veterans who transitioned to dialysis between October 2007 and September 2011, we examined the association of serum ALP levels averaged over the last 6 months of the pre-ESRD transition period ('prelude period') with all-cause, cardiovascular and infection-related mortality following dialysis initiation, using Cox (for all-cause mortality) and competing risk (for cause-specific mortality) regressions adjusted for demographics, comorbidities, medications, estimated glomerular filtration rate and serum albumin levels over the 6-month prelude period, and vascular access type at dialysis initiation...
January 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28062549/redo-procedures-for-degenerated-stentless-aortic-xenografts-and-the-role-of-valve-in-valve-transcatheter-techniques%C3%A2
#20
Herko Grubitzsch, Sebastian Zobel, Torsten Christ, Sebastian Holinski, Karl Stangl, Sascha Treskatsch, Volkmar Falk, Michael Laule
OBJECTIVES: This study evaluates reinterventions for degenerated stentless aortic xenografts. METHODS: Between 2010 and 2015, 52 consecutive patients (age 72.3 ± 9.7 years, EuroSCORE II 11.1 ± 8.9%) underwent reintervention for failed stentless aortic valves (60% porcine, 40% pericardial, 87% sub-coronary, 81% isolated/combined regurgitation). RESULTS: Based on age, EuroSCORE II, the presence of pulmonary hypertension, renal failure, a patent internal mammary artery graft and required concomitant procedures, the heart team assigned 25 patients to reoperation and 27 to valve-in-valve transcatheter aortic valve implantation (ViV-TAVI)...
January 6, 2017: European Journal of Cardio-thoracic Surgery
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