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Renal vascular access

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https://www.readbyqxmd.com/read/28735994/kidney-transplantation-using-gonadal-vein-for-venous-anastomosis-in-patients-with-iliac-vein-thrombosis-or-stenosis-a-series-of-cases
#1
J B G de Cerqueira, C M C de Oliveira, B G B Silva, L C O Santos, A G Fernandes, P F C B C Fernandes, E L Maia
BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The standard surgery uses the recipient's iliac vessels for vascular anastomosis. Thrombosis and/or stenosis of the iliac vein, which are possible complications of multiple vascular access points for dialysis, can be detected intraoperatively, constituting a surgical challenge. An infrequently reported option is the use of the gonadal vein. OBJECTIVES: This study aims to evaluate the outcomes of venous anastomosis in the gonadal vein in patients with iliac vein thrombosis and/or stenosis submitted to kidney transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28733566/newly-diagnosed-end-stage-kidney-disease-in-a-single-centre-in-sabah
#2
K W Wong, S Lojikip, F S Chan, K W Goh, H C Pang
AIM: To study the epidemiology, clinical characteristics, vascular access, and the short term survival of ESRD patients initiated on dialysis from Hospital Queen Elizabeth (HQE). BACKGROUND: The number of patients with ESRD is increasing in Sabah, Malaysia. Most patients present late and some live in remote areas with difficult access to healthcare services. Many therefore present with potentially fatal complications. METHODS: All the newly confirmed ESRD patients who were initiated on renal replacement therapy (RRT) from 1 January to 31 December 2014 were included...
June 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28712578/outcomes-readmissions-and-costs-in-transfemoral-and-alterative-access-transcatheter-aortic-valve-replacement-in-the-us-medicare-population
#3
Fenton H McCarthy, Danielle D Spragan, Danielle Savino, Taylor Dibble, Ashley C Hoedt, Katherine M McDermott, Joseph E Bavaria, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To comprehensively evaluate and compare utilization, outcomes, and especially costs of transfemoral (TF), transapical (TA), and transaortic (TAO) transcatheter aortic valve replacement (TAVR). METHODS: All Medicare fee-for-service patients undergoing TF (n = 4065), TA (n = 691), or TAO (n = 274) TAVR between January 1, 2011, and November 30, 2012, were identified using Health Care Procedure Classification Codes present on Medicare claims. Hospital charges from Medicare claims were converted to costs using hospital-specific Medicare cost-to-charge ratios...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28695556/changing-trends-in-end-stage-renal-disease-patients-with-diabetes
#4
Yimin Lu, Christina Stamm, Dina Nobre, Menno Pruijm, Daniel Teta, Anne Cherpillod, Georges Halabi, Olivier Phan, Zina Fumeaux, Roberto Bullani, Thierry Gauthier, Claudine Mathieu, Michel Burnier, Anne Zanchi
BACKGROUND: Worldwide, diabetes has become the most common cause of end-stage renal disease (ESRD), yet Swiss data are largely lacking. METHODS: This observational study examined ESRD patients with diabetes mellitus (ESRD-DM) at end of 2009 and 2014. The prevalence and characteristics of ESRD-DM patients were collected in all dialysis facilities in the Canton of Vaud of Switzerland in 2009 and in 2014, and the 5-year mortality rate was assessed. RESULTS: A total of 107 and 140 ESRD-DM patients underwent dialysis at end of 2009 and 2014, respectively...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#5
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28685192/venous-thrombosis-and-stenosis-after-peripherally-inserted-central-catheter-placement-in-children
#6
H Stella Shin, Alexander J Towbin, Bin Zhang, Neil D Johnson, Stuart L Goldstein
BACKGROUND: Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children...
July 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28666501/spontaneous-rupture-and-dissection-of-aspergillus-infected-arteriovenous-fistula
#7
Syed Nayer Mahmud, Behzad Kaleem Baloch, Muhammed Safdar, Muhammed Saeed
Patients with end stage renal disease need a vascular access like arteriovenous (AV) fistula, AV graft or central venous catheter for hemodialysis. However, AV fistula can be complicated due to infection, stenosis, ulceration etc. Among these, spontaneous rupture of AV fistula is rare and can be due to stenosis or infection. Fungal infection of AV fistula is very rare and the most common organism involved is Candida. Infection of native AV fistula with Aspergillusis not reported in the literature. This case discusses the spontaneous rupture and dissection of an Aspergillusinfected arteriovenous fistula, requiring urgent closure and repairing of vessel...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28664237/surgical-and-minimally-invasive-therapies-for-the-management-of-the-small-renal-mass
#8
REVIEW
John Withington, Joana B Neves, Ravi Barod
PURPOSE OF REVIEW: This article aims to summarise recent developments in surgical and minimally invasive therapies in the management of small renal masses (SRMs). RECENT FINDINGS: The incidence of the small renal mass is increasing. Standard management of the SRM is partial nephrectomy. More recently, use of ablative techniques to manage the SRM has been increasing and an exciting array of technical advances is currently being made in the field. Nephron-sparing surgery looks set to become more financially viable with the advent of newer robotic platforms and, potentially, even less invasive with the evaluation of single-port access...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28658026/faster-blood-flow-rate-does-not-improve-circuit-life-in-continuous-renal-replacement-therapy-a-randomized-controlled-trial
#9
Nigel Fealy, Leanne Aitken, Eugene du Toit, Serigne Lo, Ian Baldwin
OBJECTIVES: To determine whether blood flow rate influences circuit life in continuous renal replacement therapy. DESIGN: Prospective randomized controlled trial. SETTING: Single center tertiary level ICU. PATIENTS: Critically ill adults requiring continuous renal replacement therapy. INTERVENTIONS: Patients were randomized to receive one of two blood flow rates: 150 or 250 mL/min. MEASUREMENTS AND MAIN RESULTS: The primary outcome was circuit life measured in hours...
June 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28655387/hemodialysis-treatment-of-cardiorenal-syndrome
#10
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje
AIMS: We evaluated the impact of hemodialysis on mortality and hospital readmission in patients with cardiorenal syndrome. METHODS: All patients were NYHA IV functional class and underwent laboratory testing, echocardiography, and cardiac functional testing. Hemodialysis was indicated in patients with progressive decline of kidney function and consequent failure to titrate heart failure medication as well as in patients with hypervolemia that was resistant to conservative treatment with more than 4 annual hospitalizations due to heart failure and/or concomitant chronic kidney disease stage III - IV...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28649146/a-predictive-framework-to-elucidate-venous-stenosis-cfd-shape-optimization
#11
S M Javid Mahmoudzadeh Akherat, Kevin Cassel, Michael Boghosian, Mary Hammes, Fredric Coe
The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient's upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to excessive neointimal hyperplasia (NH) and subsequently stenosis. Development of a framework to monitor and predict the evolution of the venous system post access creation can greatly contribute to maintaining access patency...
July 1, 2017: Computer Methods in Applied Mechanics and Engineering
https://www.readbyqxmd.com/read/28642998/plastic-bronchitis-a-rare-complication-of-long-term-haemodialysis-catheter-placement-in-a-child
#12
Simon Carter, Dayna van de Hoef, Michael Temple, Elizabeth Harvey, Suhail Al-Saleh, Christoph Licht, Damien Noone
BACKGROUND: Despite peritoneal dialysis being the preferred mode of renal replacement therapy in neonates and infants, long-term haemodialysis may be necessary in a minority of patients with its attendant risks. CASE DIAGNOSIS/TREATMENT: This case identifies plastic bronchitis as a rare yet serious complication of long-term large bore vascular access when a vessel-sparing approach is not possible. CONCLUSIONS: An appropriately sized catheter should be used for the dialytic therapy required and to optimize access survival...
June 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28638605/effect-of-ethnicity-and-socioeconomic-status-on-vascular-access-provision-and-performance-in-an-urban-nhs-hospital
#13
Teun Wilmink, Anika Wijewardane, Kathryn Lee, Alexander Murley, Lee Hollingworth, Sarah Powers, Jyoti Baharani
BACKGROUND: The aim of this study was to examine the effect of ethnicity, socioeconomic group (SEG) and comorbidities on provision of vascular access for haemodialysis (HD). METHODS: This was a retrospective review of two databases of HD sessions and access operations from 2003-11. Access modality of first HD session and details of transplanted patients were derived from the renal database. Follow-up was until 1 January 2015. Primary failure (PF) was defined as an arteriovenous fistula (AVF) used for fewer than six consecutive dialysis sessions...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28629676/percutaneous-nephrolithotomy-puncture-and-tract-dilation-evidence-on-the-safety-of-approaches-to-the-infundibulum-of-the-middle-renal-calyx
#14
Panagiotis Kallidonis, Christina Kalogeropoulou, Iason Kyriazis, Dimitrios Apostolopoulos, Panagiotis Kitrou, Dimitrios Kotsiris, Panteleimon Ntasiotis, Evangelos Liatsikos
OBJECTIVES: To investigate the anatomical relations of the papillary, infundibular and pelvic approach to percutaneous nephrolithotomy (PCNL) and evaluate the amount of vascularization at the respective sites. MATERIALS: (99m)Tc-dimercaptosuccinic acid SPECT/CT renal scintigraphies or Computerized tomographies perfusion (CTP) were performed in 40 patients (prone n=20 or supine position n=20). The angle of approach (AoA) for access tracts the respective regions of interest (ROIs) to the mid-calyceal papilla and infundibulum as well as renal pelvis were designed and compared...
June 16, 2017: Urology
https://www.readbyqxmd.com/read/28625819/outcomes-of-relocation-of-basilic-vein-in-brachiobasilic-fistulas-in-chronic-renal-failure
#15
Farzad Kakaei, Ahad Hasankhani, Mir-Salim Seyyed-Sadeghi, Peyman Virani, Tooraj Asvadi, Sina Zarrintan
BACKGROUND: In patients without or with injured cephalic vein, using the basilic vein for creating arteriovenous fistula (AVF) is the best way for hemodialysis. In order to create AVF, the basilic vein should be superficialized and lateralized. This study sought to examine outcome of relocation of basilic vein in brachiobasilic fistulas in patients with chronic renal failure (CRF). METHODS: We evaluated the outcome of creation of brachiobasilic fistula with transposition of basilic vein in 27 patients (14 males and 13 females with mean age of 60...
June 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28616563/low-rate-of-access-site-complications-after-transradial-coronary-catheterization-a-prospective-ultrasound-study
#16
Violeta Mattea, Carsten Salomon, Niels Menck, Philipp Lauten, Frank Michael Malur, Anja Schade, Frank Steinborn, Lisa Costello-Boerrigter, Axel Neumeister, Harald Lapp
BACKGROUND: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. METHODS AND RESULTS: A total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28604317/beware-the-femoral-haemodialysis-catheter-a-surgeon-s-perspective
#17
Tinus Du Toit, David Thomson, Elmi Muller
The ability to identify and address factors that threaten the optimal utilisation of donor organs is quintessential in obtaining satisfactory transplant outcomes. We share our concerns regarding the prolonged use of femoral haemodialysis catheters and its potential to jeopardise successful renal transplantation. Despite a paucity of literature on the topic, we review relevant aspects related to this pernicious form of vascular access and clarify its limited role in the modern haemodialysis unit, particularly in patients who are still considered for transplantation...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28589209/bioengineering-in-renal-transplantation-technological-advances-and-novel-options
#18
REVIEW
Wee-Song Yeo, Yao-Chun Zhang
End-stage kidney disease (ESKD) is one of the most prevalent diseases in the world with significant morbidity and mortality. Current modes of renal replacement therapy include dialysis and renal transplantation. Although dialysis is an acceptable mode of renal replacement therapy, it does have its shortcomings, which include poorer life expectancy compared with renal transplantation, risk of infections and vascular thrombosis, lack of vascular access and absence of biosynthetic functions of the kidney. Renal transplantation, in contrast, is the preferred option of renal replacement therapy, with improved morbidity and mortality rates and quality of life, compared with dialysis...
June 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28581677/interplay-of-volume-blood-pressure-organ-ischemia-residual-renal-function-and-diet-certainties-and-uncertainties-with-dialytic-management
#19
REVIEW
Ercan Ok, Nathan W Levin, Gulay Asci, Charles Chazot, Huseyin Toz, Mehmet Ozkahya
Extracellular fluid volume overload and its inevitable consequence, hypertension, increases cardiovascular mortality in the long term by leading to left ventricular hypertrophy, heart failure, and ischemic heart disease in dialysis patients. Unlike antihypertensive medications, a strict volume control strategy provides optimal blood pressure control without need for antihypertensive drugs. However, utilization of this strategy has remained limited because of several factors, including the absence of a gold standard method to assess volume status, difficulties in reducing extracellular fluid volume, and safety concerns associated with reduction of extracellular volume...
June 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28576453/epidemiology-of-infections-and-antimicrobial-use-in-australian-haemodialysis-outpatients-findings-from-a-victorian-surveillance-network-2008-2015
#20
L J Worth, T Spelman, S G Holt, J A Brett, A L Bull, M J Richards
BACKGROUND: Patients with chronic renal failure who require haemodialysis are at high risk for infections. AIM: To determine the burden of bloodstream and local access-related infections and the prescribing patterns for intravenous antibiotics in Australian haemodialysis outpatients. METHODS: A surveillance network was established following stakeholder consultation, with voluntary participation by haemodialysis centres and data collation by the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre...
May 30, 2017: Journal of Hospital Infection
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