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dialysis catheter infection

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https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#1
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
February 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28183858/comparison-of-topical-chlorhexidine-and-mupirocin-for-the-prevention-of-exit-site-infection-in-incident-peritoneal-dialysis-patients
#2
Htay Htay, David W Johnson, Sin Yan Wu, Elizabeth L Oei, Marjorie Wai Yin Foo, Jason C Choo
♦ Objective: Prevention of exit-site infection (ESI) is of paramount importance to peritoneal dialysis (PD) patients. The aim of this study was to evaluate the effectiveness of chlorhexidine in the prevention of ESI in incident PD patients compared with mupirocin. ♦ Methods: This retrospective, pre-test/post-test observational study included all incident PD patients at Singapore General Hospital from 2012 to 2015. Patients received daily topical exit-site application of either mupirocin (2012 - 2013) or chlorhexidine (2014 - 2015) in addition to routine exit-site cleaning with 10% povidone-iodine...
February 9, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#3
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28158991/peritonitis-outcomes-in-patients-with-hiv-and-end-stage-renal-failure-on-peritoneal-dialysis-a-prospective-cohort-study
#4
Kwazi C Z Ndlovu, Wilbert Sibanda, Alain Assounga
BACKGROUND: Few studies have investigated the management of human immunodeficiency virus (HIV)-associated end-stage renal failure particularly in low-resource settings with limited access to renal replacement therapy. We aimed to evaluate the effects of HIV infection on continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis outcomes and technique failure in highly active antiretroviral therapy (HAART)-treated HIV-positive CAPD populations. METHODS: We conducted a single-center prospective cohort study of consecutive incident CAPD patients recruited from two hospitals in Durban, South Africa from September 2012-February 2015...
February 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28127728/arteriovenous-access-does-not-perform-as-well-for-plasmapheresis
#5
Mathew Wooster, Rachel Wilson, Murray Shames, Neil Moudgill
PURPOSE: Access surgeons are occasionally asked to create arteriovenous access for non-dialysis functions. Subjectively noting overall poor results, we seek to present our experience with arteriovenous access creation for apheresis. METHODS: Billing records were reviewed using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9) codes to identify patients undergoing arteriovenous access creation for diseases other than renal failure from January 2007 to August 2014...
January 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28122398/comparison-between-types-of-dressing-following-catheter-insertion-and-early-exit-site-infection-in-peritoneal-dialysis
#6
Ana Elizabeth Figueiredo, Carolina de Mattos, Cristine Saraiva, Marcia Olandoski, Pasqual Barretti, Roberto Pecoits Filho, Thyago Proença de Moraes
AIM: To investigate whether the type of dressing used (occlusive vs semi-occlusive) impacts on exit-site infection (ESI). BACKGROUND: Exit-site infections are a major predisposing factor for peritoneal dialysis (PD)-related peritonitis, the main cause of technique failure and an important cause of mortality. Care taken in exit-site dressing is considered an important procedure for the prevention of trauma and contamination of this area. Nevertheless, to our knowledge, no study has yet analyzed the impact of different dressing types on early ESI (up to 2 months after catheter insertion)...
January 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28100152/rare-iatrogenic-cardiovascular-embolization-following-dialysis
#7
Arun Sharma, Sharmila Duraisamy, Priya Jagia, Gurpreet S Gulati
Intracardiac or intrapulmonary dislodgement of dialysis catheter or guidewire coating is extremely rare. When present, it can be potentially lethal as it may get complicated by arrhythmias, myocardial or pulmonary artery rupture, valvular perforation, pulmonary thromboembolism, infarction, and infective endocarditis. Percutaneous removal should be attempted as an initial measure and is usually effective in most of the cases. We report 2 such cases, where in first patient it was the hemodialysis catheter which broke, with a large part migrating into the heart, while in second patient, it was the hydrophilic coating of the guidewire that migrated into the pulmonary arteries...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28096438/infection-prophylaxis-in-peritoneal-dialysis-patients-results-from-an-australia-new-zealand-survey
#8
Denise J Campbell, David W Mudge, Martin P Gallagher, Wai H Lim, Ranganathan Dwarakanathan, Walaa Saweirs, Jonathan C Craig
♦ Background: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ Methods: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28070047/-clinical-analysis-for-patients-with-continuous-ambulatory-peritoneal-dialysis-associated-peritonitis
#9
Jian Liu, Xun Huang, Yao Liu, Hui Xu, Rui'e Gong, Chunhui Li
To analyze the clinical characteristics of continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis in the tertiary hospitals and to discuss the preventive and therapeutic strategy.
 Methods: The clinical characteristics, pathogens, resistance and outcomes of 126 CAPD associated peritonitis in 104 patients from Jan, 2013 to June, 2016, were retrospectively analyzed.
 Results: Among the patients, the incidence rates of abdominal pain, fever, diarrhea and emesis were 104 (82.54%), 56 (44.44%), 49 (38...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28065517/peritoneal-macrophage-heterogeneity-is-associated-with-different-peritoneal-dialysis-outcomes
#10
Chia-Te Liao, Robert Andrews, Leah E Wallace, Mohd Wajid A Khan, Ann Kift-Morgan, Nicholas Topley, Donald J Fraser, Philip R Taylor
Peritonitis remains the major obstacle for the maintenance of long-term peritoneal dialysis and dysregulated host peritoneal immune responses may compromise local anti-infectious defense, leading to treatment failure. Whilst, tissue mononuclear phagocytes, comprising macrophages and dendritic cells, are central to a host response to pathogens and the development of adaptive immune responses, they are poorly characterized in the human peritoneum. Combining flow cytometry with global transcriptome analysis, the phenotypic features and lineage identity of the major CD14(+) macrophage and CD1c(+) dendritic cell subsets in dialysis effluent were defined...
January 5, 2017: Kidney International
https://www.readbyqxmd.com/read/28033679/peritoneal-dialysis-registry-with-2013-survey-report
#11
Ikuto Masakane, Takeshi Hasegawa, Satoshi Ogata, Naoki Kimata, Shigeru Nakai, Norio Hanafusa, Takayuki Hamano, Kenji Wakai, Atsushi Wada, Kosaku Nitta
Since 2009, the peritoneal dialysis (PD) registry has been carried out as part of the annual nationwide survey conducted by the Statistical Survey Committee of the Japanese Society for Dialysis Therapy with the cooperation of the Japanese Society for Peritoneal Dialysis. In this study, the current status of PD patients is reported on the basis of the results of the survey conducted at the end of 2013. The subjects were PD patients who lived in Japan and participated in the 2013 survey. Descriptive analysis was performed for various items including the current status of the combined use of PD and another dialysis method such as hemodialysis (HD) or hemodiafiltration (HDF), the method of exchanging dialysate, the use of an automated peritoneal dialysis (APD) machine, and the incidences of peritonitis and catheter exit-site infection...
December 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28025835/bedside-tunneled-dialysis-catheter-removal-a-lesson-learned-from-nephrology-trainees
#12
REVIEW
Tibor Fülöp, Mihály B Tapolyai, Mohit Agarwal, Arnaldo Lopez-Ruiz, Miklos Z Molnar, Neville R Dossabhoy
Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27993572/chills-during-hemodialysis-prediction-and-prevalence-of-bacterial-infections-a-retrospective-cohort-study
#13
D Shepshelovich, D Yelin, L Or Bach, N Halevy, Y Ziv, H Green, B Rozen-Zvi, H Ben-Zvi, J Bishara, A Gafter-Gvili, D Yahav
INTRODUCTION: Chills are a complication of patients undergoing hemodialysis. The rate of infection among hemodialysis patients presenting with chills is not well established and empirical broad spectrum antibiotics are usually the rule. METHODS: We performed a retrospective study aiming to assess the rates of infection and bacteremia in hemodialysis patients presenting with chills. We evaluated risk factors for infection and bacteremia and tested a prediction model for infection...
December 16, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27964855/a-case-of-brachiocephalic-fistula-steal-and-the-emergency-physician-s-approach-to-hemodialysis-arteriovenous-fistula-complications
#14
Erica Simon, Brit Long, Kyle Johnston, Shane Summers
BACKGROUND: Chronic kidney disease is common in the United States, with many patients maintained on hemodialysis (HD). The process of HD requires vascular access through an arteriovenous (AV) fistula, AV graft, or central venous catheter. Today, as a result of the National Kidney Foundation's "Fistula First" initiative, nearly 55% of HD patients utilize an AV fistula. As there is significant morbidity and mortality associated with fistula placement and recurrent fistula cannulation, emergency physicians must be equipped to recognize and treat fistula complications...
December 10, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27951576/future-trends-in-vascular-access-creation
#15
Surendra Shenoy
Delivery of a prescribed dialysis dose, which is critical for longevity on hemodialysis, is directly dependent on vascular access (VA). However, VA is fraught with high failure rates and has room for innovation. Arteriovenous fistula (AVF), considered the 'best choice', has a high 'failure to mature' rate. Arteriovenous grafts (AVGs) are considered when patients are poor candidates for or have failed AVF, but have a high incidence of infections and thrombosis. Due to associated morbidity and mortality from complications, central venous catheters are considered only as 'bridging short-term access' when there is an urgent need for dialysis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27942955/management-dilemmas-in-pediatric-nephrology-time-limited-trials-of-dialysis-therapy
#16
Aaron Wightman
BACKGROUND: Time-limited trials of dialysis have been proposed as a third option in addition to initiation of treatment and comfort-care only in the setting of high uncertainty or discordance between the treating team and child/family or among the treating team. CASE-DIAGNOSIS/TREATMENT: The index case was noted antenatally to have severe kidney disease and pulmonary hypoplasia. In light of the guarded, but uncertain prognosis and a lack of consensus among the treating team, as well as between the treating team and the family, a time-limited trial of dialysis was initiated...
December 9, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27935535/continuous-ambulatory-peritoneal-dialysis-in-patients-with-hiv-and-end-stage-renal-failure
#17
Kwazi C Ndlovu, Alain Assounga
♦ Background: This study aimed to evaluate the differences in continuous ambulatory peritoneal dialysis (CAPD)-related outcomes according to human immunodeficiency virus (HIV) status of end-stage renal failure patients. ♦ Methods: This prospective cohort study included 70 HIV-negative and 70 HIV-positive consecutive patients with renal failure who underwent dialysis with newly inserted Tenckhoff catheters between September 2012 and February 2015. Patients were followed up monthly at a central renal clinic for 1 year or until the primary endpoints of technique failure or death...
December 1, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27935534/representativeness-of-honeypot-trial-participants-to-australasian-pd-patients
#18
Lei Zhang, Sunil V Badve, Elaine M Pascoe, Elaine Beller, Alan Cass, Carolyn Clark, Janak de Zoysa, Nicole M Isbel, Xusheng Liu, Steven McTaggart, Alicia T Morrish, Geoffrey Playford, Anish Scaria, Paul Snelling, Liza A Vergara, Carmel M Hawley, David W Johnson
♦ Background: The HONEYPOT trial failed to establish the superiority of exit-site application of Medihoney compared with nasal mupirocin prophylaxis for the prevention of peritonitis in peritoneal dialysis (PD) patients. This study aimed to assess the representativeness of the patients in the HONEYPOT trial to the Australian and New Zealand PD population. ♦ Methods: This study compared baseline characteristics of the 371 PD patients in the HONEYPOT trial with those of 6,085 PD patients recorded on the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry...
December 1, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903856/laparoscopic-left-hemicolectomy-for-colon-cancer-in-peritoneal-dialysis-patients-a-valid-and-safe-surgical-technique-to-ensure-peritoneal-dialysis-survival
#19
Sara Auricchio, Giulio Mari, Andrea Galassi, Beatrice Dozio, Marco Pozzi, Dario Maggioni, Renzo Scanziani
A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903855/fitz-hugh-curtis-syndrome-consequent-to-a-wound-infection-following-removal-of-a-peritoneal-dialysis-catheter
#20
Tal Zilberman-Daniels, Keren Cohen-Hagai, Yael Einbinder, Alexandra Osadchy, Sydney Benchetrit, Ze'ev Korzets
Fitz-Hugh-Curtis syndrome (FHCS) is a condition characterized by inflammation of the liver capsule (perihepatitis) and adjacent peritoneal surfaces. We report a case of FHCS developing in a peritoneal dialysis (PD) patient in whom catheter removal due to recurrent peritonitis was complicated by post-operative wound infection. To the best of our knowledge, this is the first case description of FHCS in the context of PD.
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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