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https://www.readbyqxmd.com/read/28822660/prospective-randomized-study-of-long-term-hemodialysis-catheter-removal-versus-guidewire-exchange-to-treat-catheter-related-bloodstream-infection
#1
Hossam M Saleh, Mohamed M Tawfik, Hesham Abouellail
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28818188/healthcare-outcomes-in-undocumented-immigrants-undergoing-two-emergency-dialysis-approaches%C3%A2
#2
S Jawad Sher, Ranjani N Moorthi, Waqas Aftab, Sharon M Moe, Christopher S Weaver, Frank C Messina, Nancy M Martinez-Hoover, Melissa D Anderson, Michael T Eadon
BACKGROUND: Current estimates suggest 6,500 undocumented end-stage renal disease (ESRD) patients in the United States are ineligible for scheduled hemodialysis and require emergent dialysis. In order to remain in compliance with Emergency Medicaid, an academic health center altered its emergency dialysis criteria from those emphasizing interdialytic interval to a set emphasizing numerical thresholds. We report the impact of this administrative change on the biochemical parameters, utilization, and adverse outcomes in an undocumented patient cohort...
August 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28805348/levocarnitine-decreases-intradialytic-hypotension-episodes-a-randomized-controlled-trial
#3
Héctor Raúl Ibarra-Sifuentes, Ángel Del Cueto-Aguilera, Daniel Alberto Gallegos-Arguijo, Sergio Andres Castillo-Torres, Raymundo Vera-Pineda, Rolando Jacob Martínez-Granados, Alexandro Atilano-Díaz, Jesus Eduardo Cuellar-Monterrubio, Cesar Octaviano Pezina-Cantú, Edgar de Jesús Martínez-Guevara, Juan Francisco Ortiz-Treviño, Guillermo Rubén Delgado-García, José Guadalupe Martínez-Jiménez, Jesús Cruz-Valdez, Concepción Sánchez-Martínez
Intradialytic hypotension is common complication in stage 5 chronic kidney disease patients on hemodialysis. Incidence ranges from 15 to 30%. These patients have levocarnitine deficiency. A randomized, placebo-controlled quadruple-blinded trial was designed to demonstrate the levocarnitine efficiency on intradialytic hypotension prevention. Patients were randomized into four groups, to receive levocarnitine or placebo. During the intervention period, levocarnitine and placebo was administered 0 and 30 min before each hemodialysis session, respectively...
August 14, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28803369/volume-balance-and-intradialytic-ultrafiltration-rate-in-the-hemodialysis-patient
#4
REVIEW
Jason A Chou, Kamyar Kalantar-Zadeh
PURPOSE OF REVIEW: Volume management in hemodialysis patients is often challenging. Assessing volume status and deciding how much fluid to remove during hemodialysis, the so-called ultrafiltration rate (UFR), has remained a conundrum. RECENT FINDINGS: To date there is no objective assessment tool to determine the needed UFR during each hemodialysis session. Higher volume overload or higher UFR is associated with poor outcomes including worse mortality and unfavorable clinical outcomes...
August 12, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28797410/prevalence-predictors-and-clinical-presentation-of-a-calcified-nodule-as-assessed-by-optical-coherence-tomography
#5
Tetsumin Lee, Gary S Mintz, Mitsuaki Matsumura, Wenbin Zhang, Yang Cao, Eisuke Usui, Yoshihisa Kanaji, Tadashi Murai, Taishi Yonetsu, Tsunekazu Kakuta, Akiko Maehara
OBJECTIVES: This study sought to determine the anatomic characteristics and clinical presentation associated with a calcified nodule (CN) as assessed by optical coherence tomography. BACKGROUND: CN is an unusual but demonstrable cause of acute coronary syndromes (ACS). METHODS: We studied 889 de novo culprit lesions in 889 patients (48% ACS) who underwent optical coherence tomography before intervention. CN was defined as an eruptive accumulation of nodular calcification (small fractured calcifications)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28793955/optimization-of-therapeutic-drug-monitoring-of-vancomycin-in-patients-with-chronic-hemodialysis%C3%A2
#6
Lobna Ben Mahmoud, Yosr Chaabouni, Hanen Ghozzi, Houda Feriani, Ahmed Hakim, Mahmoud Kharrat, Chakib Marrakchi, Zouheir Sahnoun, Mounir Ben Jmaa, Khaled Zeghal, Jamil Hachicha
PURPOSE: To validate a simplified vancomycin monitoring algorithm in patients on chronic hemodialysis who required intravenous vancomycin for at least 3 weeks. MATERIALS AND METHODS: In this prospective study, all hemodialysis patients who were admitted between April 1, 2013, and March 31, 2015, in our unit for suspected or confirmed methicillin-resistant Staphylococcus aureus infection that required vancomycin were enrolled. All patients were categorized into two groups...
August 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28779784/drug-coated-balloon-angioplasty-for-dialysis-access-fistula-stenosis
#7
REVIEW
Auréline Boitet, Ziad A Massy, Olivier Goeau-Brissonniere, Isabelle Javerliat, Marc Coggia, Raphaël Coscas
Maintaining vascular access patency represents a tremendous challenge in hemodialysis patients. Although "native" arteriovenous fistula (AVF) is currently recommended as primary vascular access, neointimal hyperplasia stenoses frequently develop, with a risk for AVF thrombosis and vascular access loss. For years, first-line treatment of AVFs stenoses has been percutaneous transluminal angioplasty, generally with high-pressure or cutting uncoated balloons. However, restenosis and reintervention rates remain incredibly high and occur, according to recent studies, in up to 60% and 70% of patients at 6 and 12 months, respectively...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28777423/the-sleeve-method-for-creation-of-radiocephalic-arteriovenous-fistulas-in-patients-with-calcified-vessels
#8
Tomasz Gołębiowski, Wacław Weyde, Krzysztof Letachowicz, Mariusz Kusztal, Hanna Augustyniak-Bartosik, Jan Penar, Katarzyna Madziarska, Sławomir Zmonarski, Magdalena Krajewska, Marian Klinger
INTRODUCTION: Creation of an arteriovenous fistula (AVF) in patients with advanced atherosclerotic changes of the artery is often a challenge for the physician due to difficulties in suturing the vein to the side of the frangible artery. The sleeve technique relies on advancing the end of the artery into the lumen of the vein and protecting the anastomosis by adventitial sutures. MATERIAL AND METHODS: The sleeve technique was performed in 23 patients with chronic kidney disease stage IV and V and included hemodialysis patients...
July 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777420/procalcitonin-level-as-a-surrogate-for-catheter-related-blood-stream-infection-among-hemodialysis-patients
#9
Mahmoud Hamada Imam, Eman Gamal
INTRODUCTION: Catheter-related bloodstream infection (CRBSI) is a frequent complication among hemodialysis patients who usually are presented with nonspecific signs such as fever, rigors, and hypotension. Blood culture will take up to 5 days and antimicrobials will be started. Procalcitonin (PCT) is a valid marker in sepsis. Our goal in this study is to evaluate its usefulness as a diagnostic marker in detecting CRBSI among hemodialysis patients who present with suspected CRBSI. PATIENTS AND METHODS: Thirty-one hemodialysis patients with suspected CRBSI were enrolled in this study...
July 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777417/outcomes-of-three-types-of-native-arteriovenous-fistula-in-a-single-center
#10
Emiliano Chisci, Linda M Harris, Francesco Menici, Pierfrancesco Frosini, Eugenio Romano, Nicola Troisi, Leonardo Ercolini, Stefano Michelagnoli
OBJECTIVE: To study the outcomes of three different types of native arteriovenous fistula (AVF), the distal (D: radial-cephalic), middle-arm (MA: radial-cephalic) and proximal (P: brachial-cephalic) AVF access creation for hemodialysis patients in a single center. METHODS: An 8-year retrospective review, from 2006 to 2014, was conducted at a single institution in which the surgical outcomes for three different types of native AVF creation were reviewed. Preoperative duplex vein mapping was obtained in all patients to choose the best vein and site for access...
July 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28777407/management-of-hypertension-in-patients-during-percutaneous-dialysis-access-interventions
#11
Bhavika V Gandhi, Tejas B Patel, Eric J Costanzo, Avais Masud, Sushil Mehandru, Loay Salman
Not infrequently, interventionalists are faced with a patient with increased blood pressure who is about to undergo a dialysis access intervention such as tunneled hemodialysis catheter, percutaneous balloon angioplasty, or declotting procedure for a clotted arteriovenous access. This can frequently create a dilemma as functional dialysis access is needed to provide dialysis therapy and delaying treatment could result in a life-threatening situation, particularly in the presence of hyperkalemia. This article investigates hypertension in patients undergoing percutaneous dialysis access interventions and provides guidance to their management...
July 27, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#12
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28748880/incident-elderly-patients-on-peritoneal-dialysis-epidemiological-characteristics-and-modality-impact-on-survival-time
#13
Marcia R G Franco, Marcus G Bastos, Abdul R Qureshi, Alyne Schreider, Kleyton de Andrade Bastos, Jose C Divino-Filho, Natalia M S Fernandes
Aging of the population and the increased prevalence of diseases such as diabetes and arterial hypertension result in an increasing need of dialysis treatment. Herein we describe a cohort of elderly patients on peritoneal dialysis (PD) and assess the influence of the modality on the long-term survival. Out of a multicenter prospective cohort of 2,144 BRAZPD PD incident patients during a period from December 2004 to October 2007, 762 elderly adults, defined as patients ≥65-year-old, were eligible for the study, 413 started on automated PD (APD) and 349 on continuous ambulatory PD (CAPD)...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28747155/indole-3-acetic-acid-indoxyl-sulfate-and-paracresyl-sulfate-do-not-influence-anemia-parameters-in-hemodialysis-patients
#14
Stanislas Bataille, Marion Pelletier, Marion Sallée, Yvon Berland, Nathalie McKay, Ariane Duval, Stéphanie Gentile, Yosra Mouelhi, Philippe Brunet, Stéphane Burtey
BACKGROUND: The main reason for anemia in renal failure patients is the insufficient erythropoietin production by the kidneys. Beside erythropoietin deficiency, in vitro studies have incriminated uremic toxins in the pathophysiology of anemia but clinical data are sparse. In order to assess if indole 3-acetic acid (IAA), indoxyl sulfate (IS), and paracresyl sulfate (PCS) -three protein bound uremic toxins- are clinically implicated in end-stage renal disease anemia we studied the correlation between IAA, IS and PCS plasmatic concentrations with hemoglobin and Erythropoietin Stimulating Agents (ESA) use in hemodialysis patients...
July 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28745690/-gender-features-of-cardiovascular-events-in-patients-with-chronic-glomerulonephritis-at-the-pre-dialysis-stage-of-the-disease
#15
I T Murkamilov, K A Aitbaev, V V Fomin
AIM: To identify the gender differences of cardiovascular events in patients with chronic glomerulonephritis (CGN) at the pre-dialysis stage of chronic kidney disease (CKD). SUBJECTS AND METHODS: A total of 170 patients (median age 40±11 years) with CGN who did not receive hemodialysis were examined. According to gender, all patients were divided into 2 groups: 1) 66 female patients with CGN; 2) 104 male patients with CGN. All the patients underwent general clinical examination and transthoracic echocardiography...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28742406/the-efficacy-of-low-dose-tadalafil-in-patients-undergoing-hemodialysis-with-end-stage-renal-disease
#16
Mustafa Suat Bolat, İsmail Özer, Onder Cinar, Ekrem Akdeniz, Ramazan Aşcı
BACKGROUND: Erectile dysfunction (ED) is a disorder that is frequently observed in people with chronic kidney disease who undergo hemodialysis (HD). In the context of evidence-based medicine, we aimed to investigate the effect of low-dose tadalafil on sexual function in patients undergoing HD. METHODS: The medical records of 30 males (aged 29-65 years) with end-stage renal disease (ESRD) on a HD program, and who had received 5 mg tadalafil twice weekly, were retrospectively evaluated...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#17
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28714271/influence-of-residual-renal-function-in-carotid-modeling-as-a-marker-of-early-atherosclerosis-in-dialysis-patients
#18
Merita Rroji, Nereida Spahia, Saimir Seferi, Myftar Barbullushi, Goce Spasovski
Atherosclerosis is frequently present in patients with chronic kidney disease (CKD) treated with dialysis. We evaluated the association between residual renal function (RRF), phosphate level, inflammation and other risk factors in carotid modeling as a marker of early atherosclerosis in peritoneal dialysis (PD) compared with hemodialysis (HD) patients. We studied 39 stable PD and 53 HD patients on renal replacement therapy (RRT) for 3 to 36 months duration. B-mode ultrasonography was used to determine carotid artery intima media thickness (CIMT)...
July 17, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28711080/menopause-and-chronic-kidney-disease
#19
Sofia B Ahmed
Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore menses and fertility, highlighting the challenges of diagnosing and managing the menopausal transition in the female population with kidney disease. Postmenopausal sex hormone levels affect renovascular physiology, but the clinical impact of menopause on kidney function is unclear...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28710090/the-clinical-and-economic-effect-of-vascular-access-selection-in-patients-initiating-hemodialysis-with-a-catheter
#20
Alian Al-Balas, Timmy Lee, Carlton J Young, Jeffrey A Kepes, Jill Barker-Finkel, Michael Allon
Patients in the United States frequently initiate hemodialysis with a central venous catheter (CVC) and subsequently undergo placement of a new arteriovenous fistula (AVF) or arteriovenous graft (AVG). Little is known about the clinical and economic effects of initial vascular access choice. We identified 479 patients starting hemodialysis with a CVC at a large medical center (during 2004-2012) who subsequently had an AVF (n=295) or AVG (n=105) placed or no arteriovenous access (CVC group, n=71). Compared with patients receiving an AVG, those receiving an AVF had more frequent surgical access procedures per year (1...
July 14, 2017: Journal of the American Society of Nephrology: JASN
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