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https://www.readbyqxmd.com/read/28100152/rare-iatrogenic-cardiovascular-embolization-following-dialysis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
D Shepshelovich, D Yelin, Bach L Or, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27899416/peritoneal-dialysis-access-revision-in-children-causes-interventions-and-outcomes
#15
Dagmara Borzych-Duzalka, T Fazil Aki, Marta Azocar, Colin White, Elizabeth Harvey, Sevgi Mir, Marta Adragna, Erkin Serdaroglu, Rajiv Sinha, Charlotte Samaille, Juan Jose Vanegas, Jameela Kari, Lorena Barbosa, Arvind Bagga, Monica Galanti, Onder Yavascan, Giovanna Leozappa, Maria Szczepanska, Karel Vondrak, Kei-Chiu Tse, Franz Schaefer, Bradley A Warady
BACKGROUND AND OBJECTIVES: Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27875815/wang-s-forceps-assisted-catheter-reposition-and-fixation-an-easy-and-reliable-rescue-method
#16
Huiming Wang, Yujuan Wang, Xinghua Chen, Jili Zhu
Catheter migration and omental wrap are the most common causes of catheter malfunction, which usually result in catheter removal or replacement. The conventional open surgery for catheter reposition has many disadvantages. A new tunnel is needed throughout the procedure of catheter replacement causing more pain and frustration to the patients. Another drawback is that the incidence of catheter migration after conventional catheter reposition surgery is still as high as it was before the procedure. Wang's forceps, an instrument commonly used in our peritoneal dialysis center, is easy and effective in catheter insertion and fixation...
November 23, 2016: Blood Purification
https://www.readbyqxmd.com/read/27862718/peritoneal-catheter-fixation-combined-with-straight-upward-tunnel-and-low-implant-position-to-prevent-catheter-malfunction
#17
Qingyan Zhang, Chunming Jiang, Wei Zhu, Cheng Sun, Yangyang Xia, Tianfeng Tang, Cheng Wan, Qiuyuan Shao, Jing Liu, Bo Jin, Miao Zhang
AIM: Catheter malfunction is the main reason for early peritoneal dialysis (PD) technique failure. This study aimed to evaluate the effect of a new surgery technique with catheter fixation to the lower abdominal wall combined with straight upward tunnel and low implant position in reducing catheter malfunction. METHODS: Patients with end stage renal disease who received PD in our center from January 2013 to December 2015 were involved in this study. They were randomly divided into 3 groups according to surgical technique: traditional open surgery group, modified open surgery group and modified open surgery with catheter fixation group...
November 16, 2016: Nephrology
https://www.readbyqxmd.com/read/27855290/transcatheter-leadless-cardiac-pacing-the-new-alternative-solution
#18
Antoine Da Costa, Amandine Axiotis, Cécile Romeyer-Bouchard, Loucif Abdellaoui, Zahi Afif, Jean Baptiste Guichard, Antoine Gerbay, Karl Isaaz
INTRODUCTION: A lack of information about the feasibility and safety of leadless pacemaker (LPMs) exists in a fragile population of patients with limited venous anatomy access or conventional pacemaker (PM) contraindication. Accordingly, the goal of this prospective observational study was to report our experience with this new leadless technology in a subset of patients with contraindication or limited venous access. METHODS AND RESULTS: Between May 2015 and July 2016, 14 patients were consecutively included...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27843545/ochromobactrum-intermedium-an-emerging-opportunistic-pathogen-case-of-recurrent-bacteraemia-associated-with-infective-endocarditis-in-a-haemodialysis-patient
#19
T Bharucha, D Sharma, H Sharma, H Kandil, S Collier
We describe the first clinical case report of infective endocarditis related to Ochrobactrum intermedium infection. The case involved a 23-year-old man receiving dialysis via an internal jugular long-term haemodialysis catheter. He improved with a prolonged course of meropenem and minocycline. Ochrobactrum spp. are recognized as rare emerging opportunistic pathogens.
January 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/27805563/computed-tomography-for-the-management-of%C3%A2-exit-site-and-tunnel-infections-in-peritoneal-dialysis-patients%C3%A2
#20
Keina Nozaki, Yuka Kamijo, Mineo Nakatsuka, Takeshi Azuma, Tohru Nakagawa, Hideyo Miyazaki, Tetsuya Fujimura, Hiroshi Fukuhara, Haruki Kume, Yoshitaka Ishibashi, Yukio Homma
PURPOSE: To evaluate the effectiveness of computed tomography (CT) for detection of exit-site and tunnel infections with a Tenckhoff catheter. MATERIALS AND METHODS: The study enrolled patients with exit-site or tunnel infections who underwent ultrasonography (US), CT scans, and subsequent catheter removal or partial catheter reimplantation from 2010 to 2014. Control cases on peritoneal dialysis who underwent abdominal CT scans for other reasons were randomly selected...
December 2016: Clinical Nephrology
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