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https://www.readbyqxmd.com/read/27905303/peritoneal-dialysis-underscores-its-merits-in-portal-hypertensionrelated-and-nephrogenic-ascites
#1
C W H de Fijter, V Leijdekkers, D J van Leeuwen, Y F C Smets, J O Groeneveld
In the Western world, peritoneal dialysis (PD) is less frequently applied as substitute therapy in end-stage renal disease (ESRD). In the Netherlands the use of PD has decreased from 30.3 to 13.5% due to several factors, but not due to lower PD-related outcome. The lower penetrance of PD diminishes experience with and exposure of young professionals to this treatment modality. This does not enhance a free and motivated choice among renal replacement therapies for patients who cannot be transplanted pre-emptively...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27903999/burnout-syndrome-among-hemodialysis-and-peritoneal-dialysis-nurses
#2
Ayten Karakoc, Murvet Yilmaz, Nilufer Alcalar, Bennur Esen, Hasan Kayabasi, Dede Sit
INTRODUCTION: Burnout, a syndrome with 3 dimensions of emotional exhaustion, depersonalization, and reduction of personal accomplishment, is very common among hemodialysis nurses, while data are scarce regarding the prevalence of burnout syndrome (BS) among peritoneal dialysis (PD) nurses. This study aimed to assess and compare demographic and professional characteristics and burnout levels in hemodialysis and PD nurses, and to investigate factors that increase the level of burnout in dialysis nurses...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27903471/bovine-pericardium-as-new-technical-option-for-in-situ-reconstruction-of-aortic-graft-infection
#3
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVE: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infra-renal aorta using custom-made bovine pericardium grafts...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27886364/ultrasound-guided-angioplasty-for-treatment-of-peripheral-stenosis-of-arteriovenous-fistula-a-single-center-experience
#4
Sunil Kumar, Nikhil Mahajan, Shivakumar S Patil, Navdeep Singh, Soham Dasgupta, Seetharam Tejavath, Sarbpreet Singh, Deepesh B Kenwar, Ashish Sharma, Mukut Minz
PURPOSE: In patients with end-stage renal disease, arteriovenous fistulas (AVFs) are the access of choice for hemodialysis but are often complicated by stenosis. We present single-center experience of 78 ultrasound-guided angioplasty procedures for treating peripheral stenoses of AVFs. METHODS: Between January 2013 and November 2015, 78 angioplasties were performed under ultrasound guidance in 53 patients with end-stage renal disease who were referred from dialysis centers with low flow rate, difficult cannulation, increased cannulation site bleeding, immature or thrombosed AVF...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#5
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27875455/sitting-with-death
#6
Linda Jane Converse
A social worker on a dialysis unit bears witness to patients' life or death choices.
December 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#7
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27849101/-emergency-management-of-intoxications-in-the-dog-and-cat
#8
Esther Hassdenteufel, Hendrik Lehmann, Matthias Schneider, Andreas Moritz
Intoxications may lead to life-threatening emergencies. While stabilising the patient, therapy should focus on a rapid and effective elimination of the toxin. General measures for decontamination (gastrointestinal, dermal, ocular) aim to effectively decrease the absorption of the poisonous substance. Further classification of the substance and its properties can assist with the choice of specific treatment options, including dialysis and specific antidotal therapy. In recent years, treatment with lipid emulsions for enhanced elimination of lipophilic substances has become an important therapeutic option...
November 16, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/27844146/effect-of-center-practices-on-the-choice-of-the-first-dialysis-modality-for-children-and-young-adults
#9
Julien Hogan, Bruno Ranchin, Marc Fila, Jérome Harambat, Saoussen Krid, Isabelle Vrillon, Gwenaelle Roussey, Michel Fischbach, Cécile Couchoud
BACKGROUND: Peritoneal dialysis (PD) remains the modality of choice in children, but there is no clear evidence to support a better outcome in children treated with PD. We aimed to assess factors that have an impact on the choice of dialysis modality in children and young adults in France and sought to determine the roles of medical factors and center practices. METHODS: We included all patients aged <20 years at the start of renal replacement therapy (RRT), recorded in the French RRT Registry between 2002 and 2013...
November 14, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27843302/factors-influencing-access-to-education-decision-making-and-receipt-of-preferred-dialysis-modality-in-unplanned-dialysis-start-patients
#10
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter A Rutherford
OBJECTIVES: Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). METHODS: The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27831510/consolidation-in-the-dialysis-industry-patient-choice-and-local-market-competition
#11
Kevin F Erickson, Yuanchao Zheng, Wolfgang C Winkelmayer, Vivian Ho, Jay Bhattacharya, Glenn M Chertow
The Medicare program insures >80% of patients with ESRD in the United States. An emphasis on reducing outpatient dialysis costs has motivated consolidation among dialysis providers, with two for-profit corporations now providing dialysis for >70% of patients. It is unknown whether industry consolidation has affected patients' ability to choose among competing dialysis providers. We identified patients receiving in-center hemodialysis at the start of 2001 and 2011 from the national ESRD registry and ascertained dialysis facility ownership...
November 9, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27798201/selection-of-peritoneal-dialysis-among-older-eligible-patients-with-end-stage-renal-disease
#12
Ben Wong, Lorraine Venturato, Matthew J Oliver, Robert R Quinn, Pietro Ravani, Jayna Holroyd-Leduc
BACKGROUND: Older patients with end-stage renal disease (ESRD) are less likely to choose peritoneal dialysis (PD) over hemodialysis (HD). The reasons behind their choice of dialysis modality are not clear. This study seeks to determine the patient-perceived factors that influence ESRD patients' choice of dialysis modality among older ESRD patients who are deemed eligible for both PD and HD. METHODS: All patients had completed a multidisciplinary modality assessment, were deemed eligible for both PD and HD, and had received modality education...
October 25, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27797886/pharmacotherapy-of-hypertension-in-chronic-dialysis-patients
#13
Panagiotis I Georgianos, Rajiv Agarwal
Among patients on dialysis, hypertension is highly prevalent and contributes to the high burden of cardiovascular morbidity and mortality. Strict volume control via sodium restriction and probing of dry weight are first-line approaches for the treatment of hypertension in this population; however, antihypertensive drug therapy is often needed to control BP. Few trials compare head-to-head the superiority of one antihypertensive drug class over another with respect to improving BP control or altering cardiovascular outcomes; accordingly, selection of the appropriate antihypertensive regimen should be individualized...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27796620/peritoneal-dialysis-for-the-management-of-pediatric-patients-with-acute-kidney-injury
#14
Anil Vasudevan, Kishore Phadke, Hui-Kim Yap
Renal replacement therapy (RRT) is the most important supportive measure used in the management of acute kidney injury (AKI). Peritoneal dialysis (PD) is a safe, simple and inexpensive procedure and has been used in pediatric AKI patients, ranging from neonates to adolescents. It is the modality of choice for RRT in developing countries with cost constraints and limited resources. However, its use has declined with the availability of newer types of extracorporeal modalities for RRT in the developed world. Much controversy exists regarding the dosing and adequacy of PD in the management of AKI...
October 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27791257/assessing-radiocephalic-wrist-arteriovenous-fistulas-of-obtuse-anastomosis-using-computational-fluid-dynamics-and-clinical-application
#15
Jinkee Lee, Sunho Kim, Sung-Min Kim, Ryungeun Song, Hyun Kyu Kim, Jang Sang Park, Sun Cheol Park
INTRODUCTION: A radiocephalic arteriovenous fistula (AVF) is the best choice for achieving vascular access (VA) for hemodialysis, but this AVF has high rates of early failure due to juxta-anastomotic stenosis, making it impossible to use for dialysis. Low hemodynamic shear stress contributes to the pathophysiology of VA failure due to secondary thrombosis, stenosis, and re-occlusion after percutaneous intervention. METHODS: We used a computational fluid dynamics (CFDs) approach to evaluate the shear stress distribution and minimize its effects under various conditions including changes in the anastomosis angle...
November 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#16
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
https://www.readbyqxmd.com/read/27772640/intensive-hemodialysis-mineral-and-bone-disorder-and-phosphate-binder-use
#17
Michael Copland, Paul Komenda, Eric D Weinhandl, Peter A McCullough, Jose A Morfin
Mineral and bone disorder is a common complication of end-stage renal disease. Notably, hyperphosphatemia likely promotes calcification of the myocardium, valves, and arteries. Hyperphosphatemia is associated with higher risk for cardiovascular mortality and morbidity along a gradient beginning at 5.0mg/dL. Among contemporary hemodialysis (HD) patients, mean serum phosphorus level is 5.2mg/dL, although 25% of patients have serum phosphorus levels of 5.5 to 6.9mg/dL; and 13%, >7.0mg/dL. Treatment of hyperphosphatemia is burdensome...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27771192/-access-to-kidney-transplantation-s-waiting-list-setting-up-a-clinical-pathway
#18
Salvatore Citarda, Roula Galland, Jean-Michel Poux, Abdallah Guerraoui, Patrick Hallonet, Marie Lino-Daniel, Pascale Thivend, Agnès Caillette-Beaudoin
Early information about the kidney transplant is recommended to begin quickly the process of registration on the kidney transplantation waiting list, even for the patients not dialyzed at stage V of the renal insufficiency. It is a strategic choice for the patient care. From the arrival of all the patients in our center of dialysis, a systematic evaluation of the access to the kidney transplant waiting list is organized thanks to a clinical pathway. The impact of this new organization was estimated at 18 months with regard to the information about the kidney transplant transmitted to the patient, of the time required for the assessment of pre-kidney transplant evaluation, and of putting in contraindication...
October 19, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27765177/survival-after-orthotopic-heart-transplantation-in-patients-undergoing-bridge-to-transplantation-with-the-heartware-hvad-versus-the-heartmate-ii
#19
J Trent Magruder, Joshua C Grimm, Todd C Crawford, Ryan J Tedford, Stuart D Russell, Christopher M Sciortino, Glenn J R Whitman, Ashish S Shah
BACKGROUND: Our objective was to determine whether the choice of a HeartWare HVAD as opposed to a Heartmate II left ventricular assist device (HMII LVAD), impacts survival after heart transplantation after controlling for patient, donor, and center characteristics. METHODS: We queried the United Network for Organ Sharing (UNOS) database, which has recently made pretransplantation device duration available, for all adult patients undergoing bridge to transplantation (BTT) between January 2011 and March 2016...
October 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27742284/clinical-impact-of-surgical-complications-in-kidney-transplant-recipients-in-a-reference-hospital-in-salvador-bahia-brazil
#20
J C Araújo, R W D S Barbosa, M F Machado, P S Furtado, C M D Pugas, J S D A Filho, C F Lopes, R J C Mattoso, C L Neves
BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment...
September 2016: Transplantation Proceedings
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