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https://www.readbyqxmd.com/read/29127555/continuous-monitoring-of-blood-pressure-by-analyzing-the-blood-flow-sound-of-arteriovenous-fistula-in-hemodialysis-patients
#1
Yuka Kamijo, Eiichiro Kanda, Hayato Horiuchi, Noriyuki Kounoue, Keisuke Ono, Keizo Maeda, Akane Yanai, Kazuya Honda, Ryuji Tsujimoto, Mai Yanagi, Yoshitaka Ishibashi, Masayuki Yoshida
BACKGROUND: Patients with end-stage renal disease undergoing hemodialysis (HD) have an elevated risk of cardiovascular disease-related morbidity and mortality. To prevent from such a life-threatening event, the continuous blood pressure (BP) monitoring system may contribute to detect BP decline in early stages and may help to do appropriate disposal. Our research team has introduced an electronic stethoscope (Asahi Kasei Co, Ltd., Tokyo, Japan), which translates sound intensity of Arteriovenous Fistula (AVF) to BP data using the technique of Fourier transformation that can predict continuous BP non-invasively...
November 10, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29121874/evaluating-the-effectiveness-of-iv-iron-dosing-for-anemia-management-in-common-clinical-practice-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#2
Bruce M Robinson, Maria Larkina, Brian Bieber, Werner Kleophas, Yun Li, Francesco Locatelli, Keith P McCullough, Jackie G Nolen, Friedrich K Port, Ronald L Pisoni
BACKGROUND: Anemia management protocols in hemodialysis (HD) units differ conspicuously regarding optimal intravenous (IV) iron dosing; consequently, patients receive markedly different cumulative exposures to IV iron and erythropoiesis-stimulating agents (ESAs). Complementary to IV iron safety studies, our goal was to gain insight into optimal IV iron dosing by estimating the effects of IV iron doses on Hgb, TSAT, ferritin, and ESA dose in common clinical practice. METHODS: 9,471 HD patients (11 countries, 2009-2011) in the DOPPS, a prospective cohort study, were analyzed...
November 9, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29025295/ultrasonography-guided-percutaneous-microwave-ablation-for-large-hepatic-cavernous-hemangiomas
#3
Fangyi Liu, Xiaoling Yu, Ping Liang, Zhigang Cheng, Zhiyu Han, Jie Yu
PURPOSE: To evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for large hepatic cavernous hemangiomas (HCHs) with ablation of the feeding artery and aspiration of blood from hemangioma simultaneously. MATERIALS AND METHODS: From January 2011 to December 2016, 40 patients (29 females, 11male; average age 43.25±7.65 years) with 42 giant hepatic hemangiomas (mean diameter7.02±1.55cm, range4.1-10.8 cm) were treated with image-guided percutaneous MWA with ablation of the feeding artery and aspiration of blood from hemangioma simultaneously...
October 12, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29018100/randomized-crossover-trial-of-blood-volume-monitoring-guided-ultrafiltration-biofeedback-to-reduce-intradialytic-hypotensive-episodes-with-hemodialysis
#4
Kelvin C W Leung, Robert R Quinn, Pietro Ravani, Henry Duff, Jennifer M MacRae
BACKGROUND AND OBJECTIVES: Intradialytic hypotension (IDH) is associated with morbidity. The effect of blood volume-guided ultrafiltration biofeedback, which automatically adjusts fluid removal rate on the basis of blood volume parameters, on the reduction of IDH was tested in a randomized crossover trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a 22-week, single blind, randomized crossover trial in patients receiving maintenance hemodialysis who had >30% of sessions complicated by symptomatic IDH in five centers in Calgary, Alberta, Canada...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29017808/a-novel-technique-for-duplex-guided-office-based-interventions-for-patients-with-acute-arteriovenous-fistula-occlusion
#5
Afsha Aurshina, Enrico Ascher, Anil Hingorani, Natalie Marks
OBJECTIVE: The purpose of the study was to aggressively salvage acutely occluded arteriovenous fistulas (AVFs) using duplex imaging as the sole imaging modality for percutaneous transluminal angioplasty of acutely thrombosed AVF. METHODS: Over a period of 12 months, 14 patients with acute thrombosis of their AVFs underwent 18 procedures in a single center for AVF salvage. All 14 patients presented with chronic renal failure, and six were diabetic. All patients were treated under duplex guidance alone...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28992908/evaluation-of-pericardial-effusion-in-dogs-and-successful-treatment-using-a-hemodialysis-fistula-needle-a-retrospective-study
#6
REVIEW
Bartolo Celona, Chiara Crinò, Elisabetta Giudice, Simona Di Pietro
The aim of this retrospective study was to assess epidemiology and echocardiographic findings of pericardial effusion in canine patients and to determine the clinical usefulness and safety of a new pericardiocentesis technique, using a "fistula needle" for hemodialysis. A database of 5304 dogs of different breeds, age, gender, type, and severity of the cardiac disease, referred for a specialist cardiology and echocardiographic examination from 2009-2016, was reviewed. All the dogs were subjected to echocardiography; when possible and required, an echo-guided pericardiocentesis was performed by mean of a 17G "fistula needle" commonly used for hemodialysis...
June 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28948800/-simple-technique-of-percutaneous-ligation-of-accessory-veins-for-salvage-of-failing-arteriovenous-fistulae
#7
M Šercl, V Machačka, P Kočí, V Mellanová, L Endrych
INTRODUCTION: Non-maturing arteriovenous fistula is a common problem in hemodialysis units. The main reasons for maturation failure include a poor venous system, vein stenosis, stenosis in an anastomosis, or the presence of collateral veins. Currently, the usual approach to eliminate collateral vein drainage consists in surgical ligation or coil embolization; however, these procedures are time-consuming, logistically demanding and expensive. Alternatively, various types of percutaneous ligation are done...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28941049/body-composition-and-inflammation-in-hemodialysis-patients
#8
Ante Mandic, Ivan Cavar, Ivana Skoro, Ivan Tomic, Kristina Ljubic, Slavica Coric, Ivanka Mikulic, Igor Azinovic, Danijel Pravdic
The volume state of dialysis patients is important in guiding the dialysis process. Volume overload in these patients is associated with inflammation. The objectives of the present study were to assess the body composition of patients on hemodialysis; to determine the concentrations of B-type natriuretic peptide (BNP) in plasma and evaluate the association of BNP concentrations with volume overload; to determine the concentrations of C-reactive protein (CRP), albumin and superoxide dismutase (SOD) activities as indicators of inflammatory or antioxidant processes...
September 22, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28938954/blood-pressure-targets-for-hemodialysis-patients
#9
REVIEW
Jeffrey M Turner, Aldo J Peixoto
The association between blood pressure (BP) and mortality is unique in hemodialysis patients compared with that in the general population. This is because of an altered benefit-risk balance associated with BP reduction in these patients. An adequately designed study comparing BP targets in hemodialysis patients remains to be conducted. The current evidence available to guide dialysis providers regarding treatment strategies for managing hypertension in this population is limited to large observational studies and small randomized controlled trials...
October 2017: Kidney International
https://www.readbyqxmd.com/read/28934936/transitional-cell-carcinoma-involving-graft-kidney-in-a-kidney-transplant-recipient-a-case-report
#10
Yu Ah Hong, Hyeon Seok Hwang, Hae Joung Sul, Suk Young Kim, Yoon Kyung Chang
BACKGROUND: Kidney transplantation (KT) is the treatment option for patients with end stage renal disease (ESRD) to prolong survival and improve quality of life. Although the use of potent immunosuppressive agents increases graft survival in kidney transplantation recipients (KTRs), it may lead to the development of malignancy, including transitional cell carcinoma (TCC). TCC developing in the pelvis of graft kidney is very rare in KTRs. CASE PRESENTATION: A 40-year-old male visited hospital with complaints of nausea, vomiting and gross hematuria...
September 21, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28899228/intraoperative-venoplasty-to-facilitate-placement-of-tunneled-catheters-for-hemodialysis
#11
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective With the implementation of the K-DOQI guidelines, more patients are in need of long-term dialysis catheters until maturation of the arteriovenous fistula. However, on occasion, when placing a tunneled cuffed catheter for hemodialysis, we have encountered difficulty with passing the guidewire in spite of demonstration of a patent cervical portion of the internal jugular vein on duplex. Herein, we review our experience with intraoperative venoplasty for placement of Tesio™ catheters (Medcomp Harleysville, PA)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28832356/blood-pressure-in-hemodialysis-targets
#12
Panagiotis I Georgianos, Rajiv Agarwal
PURPOSE OF REVIEW: In the absence of 'hard' clinical-trial evidence to define optimal blood pressure (BP) targets and validate different BP measurement techniques, management of hypertension in hemodialysis is based on expert opinions. In this review, we provide a comparative evaluation of out-of-dialysis BP monitoring versus dialysis-unit BP recordings in diagnosing hypertension, guiding its management and prognosticating mortality risk. RECENT FINDINGS: Owing to their high variability and poor reproducibility, predialysis and postdialysis BP recordings provide inaccurate reflection of the actual BP load outside of dialysis...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28796425/comparison-of-stroke-volume-measurements-during-hemodialysis-using-bioimpedance-cardiography-and-echocardiography
#13
Michael J Germain, Jyovani Joubert, Daniel O'Grady, Brian H Nathanson, Yossi Chait, Nathan W Levin
BACKGROUND: Fluid management remains a major challenge of hemodialysis (HD) care, with serious implications for morbidity and mortality. Intradialytic fluid management is typically guided by blood pressure, an indirect resultant of hemodynamics status. Direct measurements of hemodynamic parameters may improve cardiovascular outcomes by providing rational bases for intervention. We compare stroke volume (SV) measurements using a noninvasive, regional biompedance cardiography device (NiCaS) with Doppler echocardiography (Echo) in HD setting...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28745842/toxic-alcohol-ingestion-prompt-recognition-and-management-in-the-emergency-department-digest
#14
Gillian A Beauchamp, Matthew Valento, Jeremy Kim
Identifying patients with potential toxic alcohol exposure and initiating appropriate management is critical to avoid significant patient morbidity. Sources of toxic alcohol exposure include ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropanol. Treatment considerations include the antidotes fomepizole and ethanol, and hemodialysis for removal of the parent compound and its toxic metabolites. Additional interventions include adjunctive therapies that may improve acidosis and enhance clearance of the toxic alcohol or metabolites...
September 22, 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28731382/external-validation-and-clinical-utility-of-a-prediction-model-for-6-month-mortality-in-patients-undergoing-hemodialysis-for-end-stage-kidney-disease
#15
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#16
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/28709598/simplifying-the-hemodialysis-prescription-in-patients-with-ethylene-glycol-poisoning
#17
Darren M Roberts, Tom N Lea-Henry
The management of ethylene glycol poisoning is multimodal and usually includes hemodialysis. The usual approach for guiding treatment duration is iterative, based on serial measurements of ethylene glycol concentration and routine biochemistry. In this issue, Iliuta et al. present a simplified approach to determining the duration of hemodialysis based on a single ethylene glycol concentration. Although this appears reasonable in many cases, there are circumstances in which further consideration is warranted and it only applies to high-efficiency intermittent hemodialysis...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28700182/-brachial-artery-pseudoaneurysm-a-rare-but-serious-complication-in-hemodialysis-patients-with-arteriovenous-fistula
#18
Andrea Mancini, Giuseppe Castriotta, Pernina Angelini, Michele Bozzi, Vincenzo Giancaspro, Elvira La Raia, Maria Teresa Nisi, Anna Rita Proscia, Giuseppe Tarantino, Ottavia Vitale, Cristoforo Cuzzola
A pseudoaneurysm or false aneurysm of the brachial artery is an uncommon occurrence in patients receiving hemodialysis with arteriovenous fistula (AVF). We describe the case of a 76-year-old woman presenting with a large, tender, pulsatile mass in the right antecubital region 10 cm from the AVF. B-mode ultrasound examination revealed a saccular hematoma. Color doppler showed a recirculation movement of blood, creating a two colors image called "Korean flag". The patient was transferred to the surgical unit where she first underwent ultrasound-guided compression and then surgical repair of the pseudoaneurysm...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28672146/stroke-volume-guided-resuscitation-in-severe-sepsis-and-septic-shock-improves-outcomes
#19
Heath E Latham, Charles D Bengtson, Lewis Satterwhite, Mindy Stites, Dipti P Subramaniam, G John Chen, Steven Q Simpson
To determine whether stroke volume (SV) guided fluid resuscitation in patients with severe sepsis and septic shock alters Intensive Care Unit (ICU) fluid balance and secondary outcomes, this retrospective cohort study evaluated consecutive patients admitted to an ICU with the primary diagnosis of severe sepsis or septic shock. Cohorts were based on fluid resuscitation guided by changes in SV or by usual care (UC). The SV group comprised 100 patients, with 91 patients in the UC group. Net fluid balance for the ICU stay was lower in the SV group (1...
June 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28652444/reticulocyte-hemoglobin-content-helps-avoid-iron-overload-in-hemodialysis-patients-a-retrospective-observational-study
#20
Domenico Capone, Mauro Cataldi, Mauro Vinciguerra, Teresa Mosca, Salvatore Barretta, Annalisa Ragosta, Aniello Sorrentino, Alessandra Vecchione, Luca Barretta, Giovanni Tarantino
BACKGROUND/AIM: Anemia in patients suffering from end-stage renal failure is currently treated with Erythropoiesis-Stimulating Agents (ESA). This treatment needs sufficient iron supplementation to avoid an inadequate dosage of ESA. Nowadays modern analytical instruments allow to accurately calculate the content of Hemoglobin (Hb) in reticulocytes (CHr), that can be used as a guide for prescribing patients with the appropriate amount of iron. PATIENTS AND METHODS: Patients, undergoing hemodialysis, were retrospectively selected from the database and were divided in two groups: group A received intravenous (IV) iron and subcutaneously ESA, and their dosages were adjusted on the basis of the following parameters: Hb, Mean corpuscular haemoglobin (MCH), CHr with consequent MCH/CHr ratio and reticulocyte count determined by the ADVIA 120 Hematology System of Siemens; group B patients were administered IV iron and ESA monitoring iron storage, Hb and ferritin...
July 2017: In Vivo
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