Amy Barton Pai, Matthew D McGuire, Karen N Davidge, Michael C Dean, Gabrielle M Costello, Ernane Souza, Sushovita Mukherjee, Michael Heung, Alexander S Yevzlin, Lenar T Yessayan
Tunneled central venous catheters (TCVCs) are colonized by Gram-positive organisms and form biofilm. Lipoteichoic acid (LTA) is a Gram-positive cell wall component that can be measured in serum. The purpose of this pilot study was to characterize LTA concentrations in hemodialysis (HD) patients with TCVCs compared to other access types and to evaluate biofilm morphology and microbiology in TCVCs removed by clinical decision. The study enrolled patients with TCVCs (18), grafts (19), and fistulas (18). Blood samples were collected before HD, at 30 minutes, 2 hours, and end of HD...
August 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
David Packer, James S Kaufman
No abstract text is available yet for this article.
May 2020: Kidney medicine
Sophia V Kazakova, James Baggs, Ibironke W Apata, Sarah H Yi, John A Jernigan, Duc Nguyen, Priti R Patel
Rationale & Objective: Most new patients with end-stage renal disease (ESRD) initiate hemodialysis (HD) with a central venous catheter (CVC) and later transition to a permanent vascular access with lower infection risk. The benefit of early fistula use in preventing severe infections is incompletely understood. We examined patients' first access and subsequent transitions between accesses during the first year of HD to estimate the risk for bloodstream infection (BSI) associated with incident and time-dependent use of HD access...
May 2020: Kidney medicine
Medha Airy, Colin R Lenihan, Victoria Y Ding, Maria E Montez-Rath, Jizhong Cheng, Sankar D Navaneethan, Haimanot Wasse, Wolfgang C Winkelmayer
Rationale & Objective: Vascular access type (arteriovenous fistula [AVF] vs arteriovenous graft [AVG] vs central venous catheter [CVC]) associates with clinical outcomes in patients with end-stage kidney disease undergoing hemodialysis. Whether a similar association exists with outcomes after kidney transplantation is unknown. We hypothesized that AVGs would associate with worse outcomes, perhaps owing to persistent subclinical inflammation. Study Design: Retrospective cohort study...
November 2019: Kidney medicine
Gulsah Kaya Aksoy, Mesiha Ekim, Sevcan A Bakkaloğlu, Seda Coşkun, Ali Delibaş, Seçil Conkar, Dilek Yılmaz, Aslıhan Kara, Seha K Saygılı, Bahar Büyükkaragöz, Zeynep Y Yıldırım, Elif Çomak, Metin K Gürgöze, Lale Sever, Aytül Noyan, Aysun K Bayazıt, Ruhan Düşünsel
BACKGROUND: Peritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related non-infectious complications and the predisposing factors. METHODS: Retrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated...
July 29, 2020: Pediatric Nephrology
Victor Castro, Alik Farber, Yixin Zhang, Quinten Dicken, Logan Mendez, Scott R Levin, Thomas W Cheng, Rebecca B Hasley, Jeffrey J Siracuse
OBJECTIVES: Tunneled dialysis catheters (TDC) are generally used as temporary means to provide hemodialysis until permanent arteriovenous (AV) access is established. However, some patients may end up having long-term catheter-based hemodialysis due to the lack of alternatives for other dialysis access. Our objective was to evaluate patient characteristics, reasons for, and mortality associated with long-term TDC use. METHODS: A retrospective single institution analysis was performed...
July 21, 2020: Journal of Vascular Surgery
Satinderjit Locham, Isaac Naazie, Joseph Canner, Jeffrey Siracuse, Omar Al-Nouri, Mahmoud Malas
BACKGROUND: Sepsis is one the most serious and life-threatening complication in patients with chronic hemodialysis access (HD). Arteriovenous fistula (AVF) use is associated with lower risk of infection. However, several prior studies identified significantly higher number of patients initiating hemodialysis using catheter (HC) or graft (AVG). The aim of this study is to use a large national Renal Database to report the incidence and risk factors of Sepsis in patients with end stage renal disease (ESRD) initiating hemodialysis access using AVF, AVG or HC in the United States...
July 21, 2020: Journal of Vascular Surgery
Adriano Carvalho Guimarães, Ana Maria Marques Fracaro Mansano, José Roberto Boselli Júnior, Carolina Lorejam Crespo, Ricardo Herkenhoff Moreira, Afonso Henrique V Teixeira da Cunha, Filipe Cézar Bertassoni de Souza, Walter Jr Boim de Araujo
INTRODUCTION: Vascular access dysfunction and the depletion of access pathways are complications associated with morbidity and mortality in dialysis patients. As described in the literature, catheter insertion through small collateral veins or recanalized cervical and thoracic veins is an attractive option. CASE DESCRIPTION: This article reports a case in which a collateral vein in the abdominal region was used as an access for hemodialysis. CONCLUSION: After multiple attempts with fistulas and catheters, the left abdominal wall collateral network proved to be a successful access site...
July 23, 2020: Journal of Vascular Access
Angelo Karaboyas, Hal Morgenstern, Sandra Waechter, Nancy L Fleischer, Raymond Vanholder, Stefan H Jacobson, Manish M Sood, Douglas E Schaubel, Masaaki Inaba, Ronald L Pisoni, Bruce M Robinson
Background: Anemia at hemodialysis (HD) initiation is common. Correcting low hemoglobin (Hgb) before HD initiation may improve survival by avoiding potential harms of chronic anemia, high doses of erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron in the early HD period, and/or rapid Hgb rise. Methods: We included 4604 incident HD patients from 21 countries in the Dialysis Outcomes and Practice Patterns Study Phases 4-5 (2009-15). Because low Hgb at HD start may reflect comorbidity or ESA hyporesponse, we restricted our analysis to the 80% of patients who achieved Hgb ≥10 g/dL 91-120 days after HD start (Month 4)...
June 2020: Clinical Kidney Journal
Sudeep Acharya, Shamsuddin Anwar, Michael Iannuzzi, Viswajit Anugu, Foad Ghavami
Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks...
June 16, 2020: Curēus
Tristen T Chun, Dejah R Judelson, David Rigberg, Peter F Lawrence, Robert Cuff, Sherene Shalhub, Max Wohlauer, Christopher J Abularrage, Papapetrou Anastasios, Shipra Arya, Bernadette Aulivola, Melissa Baldwin, Donald Baril, Carlos F Bechara, William E Beckerman, Christian-Alexander Behrendt, Filippo Benedetto, Lisa F Bennett, Kristofer M Charlton-Ouw, Amit Chawla, Matthew C Chia, Sungsin Cho, Andrew M T L Choong, Elizabeth L Chou, Anastasiadou Christiana, Raphael Coscas, Giovanni De Caridi, Sharif Ellozy, Yana Etkin, Peter Faries, Adrian T Fung, Andrew Gonzalez, Claire L Griffin, London Guidry, Nalaka Gunawansa, Gary Gwertzman, Daniel K Han, Caitlin W Hicks, Carlos A Hinojosa, York Hsiang, Nicole Ilonzo, Lalithapriya Jayakumar, Jin Hyun Joh, Adam P Johnson, Loay S Kabbani, Melissa R Keller, Manar Khashram, Issam Koleilat, Bernard Krueger, Akshay Kumar, Cheong Jun Lee, Alice Lee, Mark M Levy, C Taylor Lewis, Benjamin Lind, Gabriel Lopez-Pena, Jahan Mohebali, Robert G Molnar, Nicholas J Morrissey, Raghu L Motaganahalli, Nicolas J Mouawad, Daniel H Newton, Jun Jie Ng, Leigh Ann O'Banion, John Phair, Zoran Rancic, Ajit Rao, Hunter M Ray, Aksim G Rivera, Limael Rodriguez, Clifford M Sales, Garrett Salzman, Mark Sarfati, Ajay Savlania, Andres Schanzer, Mel J Sharafuddin, Malachi Sheahan, Sammy Siada, Jeffrey J Siracuse, Brigitte K Smith, Matthew Smith, Ina Soh, Rebecca Sorber, Varuna Sundaram, Scott Sundick, Tadaki M Tomita, Bradley Trinidad, Shirling Tsai, Ageliki G Vouyouka, Gregory G Westin, Michael S Williams, Sherry M Wren, Jane K Yang, Jeniann Yi, Wei Zhou, Saqib Zia, Karen Woo
INTRODUCTION: During the COVID-19 pandemic, central venous access line teams were implemented at many hospitals throughout the world to provide access for critically ill patients. The objective of this study was to describe the structure, practice patterns and outcomes of these vascular access teams during the COVID-19 pandemic. METHODS: We conducted a cross sectional, self-reported study of central venous access line teams in hospitals afflicted with the COVID-19 pandemic...
July 15, 2020: Journal of Vascular Surgery
Ladan Golestaneh, Kerri L Cavanaugh, Yungtai Lo, Angelo Karaboyas, Michal L Melamed, Tanya S Johns, Keith C Norris
RATIONALE AND OBJECTIVE: Community racial composition has been shown to be associated with mortality in patients with ESKD. It is unclear whether living in communities with predominantly black residents is also associated with risk for hospitalization among patients receiving hemodialysis. STUDY DESIGN: Retrospective analysis of prospectively collected data from a cohort of patients on hemodialysis. SETTING AND PARTICIPANTS: 4567 patients treated in 154 dialysis facilities located in 127 unique zip codes and enrolled in United States Dialysis Outcomes and Practice Patterns Study (US-DOPPS), phases 4-5 (2010-2015)...
July 12, 2020: American Journal of Kidney Diseases
Fatai Oluyadi, Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Ezra Schrem, Ayesha Anwar, Moro O Salifu, Samy I McFarlane
Background: Healthcare related bacterial endocarditis represents a significant portion of endocarditis seen today. Suspicion for these infections should be particularly high in patients with chronic indwelling central venous catheters, and most notably, in patients with hemodialysis catheters. These infections may have a predilection for the superior vena cava due to proximity of the catheters to the great veins of the neck. Transthoracic echocardiography and/or trans-esophageal echocardiography should be done promptly in patients in which there a high suspicion for such infections, in order to identify these lesions, and guide appropriate management with either antibiotics or surgical intervention...
2020: American Journal of Medical Case Reports
Sabahat Afshan, Truman M Earl, Christopher D Anderson, Mehul Dixit
BACKGROUND Peritoneal dialysis (PD) has benefits over hemodialysis (HD), including the ability of daily performance at home without interfering with important activities such as school attendance in children. However, there are risks and complications associated with it. This is the third pediatric case report of a dormant PD catheter tip perforating the colon and protruding through the anus, but without peritonitis, as would be highly expected. CASE REPORT A 12-year-old male with ESRD secondary to obstructive uropathy received a pre-emptive deceased donor kidney transplant that failed within a few days due to thrombosis secondary to factor V Leiden deficiency...
July 16, 2020: American Journal of Case Reports
Maxwell F Kilcoyne, Chi Chi Do-Nguyen, Achintya Moulick, Nandini Madan, Vicki Mahan, Susan Conley, Paul S Brady, Eric D Endean, Randy M Stevens
BACKGROUND: Left innominate vein occlusion is a known complication of pacemaker and central venous catheter placement. For dialysis-dependent patients with an arteriovenous fistula (AVF), this can prevent successful hemodialysis and may require surgical intervention. CASE REPORT: An 8-month-old male was diagnosed with hemolytic uremic syndrome and became dialysis-dependent at 11 months of age. After multiple vascular access and peritoneal dialysis complications, the patient had construction of a brachiobasalic AVF in his left arm at 13 years old...
July 11, 2020: Journal of Cardiac Surgery
Francesca Zanoni, Laura Pavone, Valentina Binda, Giovanni Tripepi, Graziella D'Arrigo, Antonio Scalamogna, Piergiorgio Messa
BACKGROUND: Central venous catheter use is rising in chronic and acute hemodialysis. Catheter-related bloodstream infections are a major complication of central venous catheter use. This article examines clinical factors associated with catheter-related bloodstream infections incidence. METHODS: In this retrospective, single-center study, 413 patients undergoing extracorporeal treatments between 1 February 2014 and 31 January 2017 with 560 central venous catheters were recruited...
July 10, 2020: Journal of Vascular Access
Carole Philipponnet, Julien Aniort, Bruno Pereira, Kazra Azarnouch, Mohammed Hadj-Abdelkader, Pascal Chabrot, Anne-Elisabeth Heng, Bertrand Souweine
Introduction: The last decade has seen a steady increase worldwide in the prevalence of end-stage renal disease (ESRD). Hemodialysis is the major modality of renal replacement therapy (RRT) in 70% to 90% of patients, who require well-functioning vascular access for this procedure. The recommended access for hemodialysis is an arteriovenous fistula or a vascular graft. However, recourse to central venous catheters remains essential for patients whose chronic renal disease is diagnosed at the end stage or in whom an arteriovenous fistula cannot be created or maintained...
July 2020: KI Reports
Diego Ennes Gonzalez, Renato Demarchi Foresto, Ana Luiza Santos Maldonado, Wallace Stwart Carvalho Padilha, Fernanda Badiani Roberto, Maria Eduarda Vilanova da Costa Pereira, Marcelino de Souza Durão Junior, Aluizio Barbosa Carvalho
INTRODUCTION: The clinical impact of vascular calcification is well established in the context of cardiovascular morbidity and mortality, but other clinical syndromes, such as calciphylaxis, although less frequent, have a significant impact on chronic kidney disease. METHODS: Case report of a 27-year-old woman, who had complained of bilateral pain in her toes for 3 days, with the presence of small necrotic areas in the referred sites. She had a history of type 1 diabetes (25 years ago), with chronic kidney disease, on peritoneal dialysis, in addition to rheumatoid arthritis...
July 8, 2020: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Catarina Abrantes, Elsa Soares, Patrícia Valério, Teresa Furtado, Carlos Barreto
Patients requiring renal replacement therapy remain a significant burden on the healthcare system. A substantial amount of hospitalization costs for these patients are related to vascular complications, especially catheter-related thrombosis, which is associated with a significant increase in morbidity and mortality. We report the case of a male patient with multiple myeloma (MM) and dialysis-dependent renal failure due to light-chain cast nephropathy, who presented recurrent early catheter dysfunction. A large thrombus was detected, extending from the superior vena cava (SVC) to the right atrium (RA) and later at the inferior vena cava (IVC), ultimately leading to exhaustion of vascular capital...
June 4, 2020: Curēus
Ryutaro Fujitsuna, Fumie Sugihara, Daisuke Yasui, Hidemasa Saito, Tatsuo Ueda, Sayaka Shirai, Taiga Matsumoto, Yasuo Miyagi, Shin-Ichiro Kumita
Delayed vascular injury (DVI) with a hemodialysis catheter is a rare but potentially life-threatening complication. However, the appropriate treatment for DVI has not yet been established. A 44-year-old man underwent placement of a hemodialysis catheter via the left internal jugular vein, and the first leukapheresis procedure was performed without complications. However, 3 days after the insertion of the hemodialysis catheter, the patient developed sudden dyspnea. Chest radiographs and contrast-enhanced computed tomography revealed that the catheter tip had migrated and was located outside the left brachiocephalic vein...
September 2020: Radiology Case Reports
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