Jongtak Jung, Kyoung-Ho Song, Kang Il Jun, Chang Kyoung Kang, Nak-Hyun Kim, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang-Won Park, Nam Joong Kim, Myoung-Don Oh, Hong Bin Kim
BACKGROUND: Although the risk factors for positive follow-up blood cultures (FUBCs) in gram-negative bacteremia (GNB) have not been investigated extensively, FUBC has been routinely carried out in many acute care hospitals. We attempted to identify the risk factors and develop a predictive scoring model for positive FUBC in GNB cases. METHODS: All adults with GNB in a tertiary care hospital were retrospectively identified during a 2-year period, and GNB cases were assigned to eradicable and non-eradicable groups based on whether removal of the source of infection was possible...
September 17, 2020: BMC Infectious Diseases
Mahmood K Razavi
INTRODUCTION: The development of thoracic central venous obstruction (TCVO) leads to narrowing of the vessel lumen which impacts blood flow and the placement of central venous access. The most common cause of TCVO is central venous catheters (CVCs) which can induce intravascular scarring or endoluminal obstruction via thrombus formation. AREAS COVERED: The Surfacer® System is used to obtain central venous access (CVA) in patients with TCVO by facilitating catheter insertion via the novel Inside-Out® approach...
September 17, 2020: Expert Review of Medical Devices
Joshua Carson Doverspike, Shale J Mack, Amy Lou, Blake Stringer, Shelby Reno, Marie S Cornell, Alvaro Rojas-Pena, Jianfeng Wu, Chuanwu Xi, Alexander Yevzlin, Mark E Meyerhoff
The use of tunneled dialysis catheters (TDCs) for patients in need of hemodialysis treatments (HDs) cause a significant number of blood stream infections (BSIs), with very few viable preventative/treatment methods. Use of antibiotics are relatively ineffective due to the development of multi-drug resistant bacterial strains and their inability to penetrate bacterial biofilms. Nitric oxide (NO) is an endogenous gas molecule that has broad spectrum antimicrobial/anti-biofilm activity. In this study, the potential of creating a NO releasing insert device that is attached onto the hub region cap of TDCs and locally releases NO within the TDC hub is evaluated for its antimicrobial/anti-biofilm effectiveness...
September 15, 2020: ACS Applied Materials & Interfaces
Yuliang Zhao, Letian Yang, Yating Wang, Huawei Zhang, Tianlei Cui, Ping Fu
The objective is to compare Multi-detector CT angiography (MDCTA) and digital subtraction angiography (DSA) in diagnosing hemodialysis catheter related-central venous stenosis (CVS). During a period of 6 years, hemodialysis patients with suspected catheter related-CVS who received both MDCTA and DSA were retrospectively enrolled. We analyzed the sensitivity, specificity, accuracy, Cohen's kappa coefficient (κ) and other diagnostic parameters for MDCTA compared to DSA. A total of 1533 vascular segments in 219 patients were analyzed...
September 14, 2020: Phlebology
Yoshinosuke Shimamura, Takuto Maeda, Koki Abe, Hideki Takizawa
The use of tunneled cuffed catheters (TCCs) for permanent blood access is increasing as the hemodialysis population ages. However, the higher mortality and complication rates associated with their use have been significant concerns. This single-center observational cohort study aimed to investigate clinical factors affecting mortality and complications in Japanese hemodialysis patients with a TCC.We enrolled 64 consecutive patients receiving hemodialysis through a TCC between 2012 and 2019. The primary outcome was all-cause mortality and the secondary outcome was the incidence of catheter-related complications at 2 years...
September 11, 2020: Medicine (Baltimore)
J Dotis, A Kondou, E Koukloumperi, V Karava, A Papadopoulou, C Gkogka, N Printza
Fungal peritonitis in patients undergoing peritoneal dialysis (PD) is very difficult to treat and is associated with significant morbidity and mortality. Among fungal pathogens, Aspergillus peritonitis presents a higher mortality rate when compared to Candida peritonitis and its identification as well as appropriate treatment remains a challenge for the physicians. We critical reviewed all published cases in literature of Aspergillus peritonitis in PD patients. The results showed that a total of 55 cases (51% males) of Aspergillus peritonitis in PD patients were reported from 1968 to 2019...
August 20, 2020: Journal de Mycologie Médicale
Erdem Bİrgİ, Hasanalİ Durmaz
BACKGROUND/AIM: It is aimed to describe the technical success of the micropuncture technique performed in placement of tunneled hemodialysis catheters in patients with central venous occlusion and limited access. MATERIALS AND METHODS: A total of 25 patients with central venous occlusion and in need for catheter placement for hemodialysis between 2012 and 2018 were included in this study and analyzed retrospectively. Technical success was defined as the placement of tunneled dialysis catheters with optimal position and function...
September 6, 2020: Turkish Journal of Medical Sciences
Rupesh Raina, Aliza Mittal, Sidharth Kumar Sethi, Ronith Chakraborty
The incidence and prevalence of renal replacement therapy has continued to increase in the pediatric population. Recent data have shown that hemodialysis was the most frequently used dialysis modality, especially in pediatric ESRD patients (age 0-21 years). A well-functioning vascular access is required for effective hemodialysis and choosing the best vascular access option for pediatric patients can be difficult. Pediatric vascular options include arteriovenous fistula, arteriovenous graft, and central venous catheters (CVCs)...
May 2020: Advances in Chronic Kidney Disease
Ali I Gardezi, Adrian Sequeira, Rajeev Narayan
The cost and health burden of ESRD continues to increase globally. Total Medicare expenditure on dialysis has increased from 229 million USD in 1973 to 35.4 billion USD in 2016. Dialysis access can represent almost a tenth of these costs. Central venous catheters have been recognized as a significant factor driving costs and mortality in this population. Home dialysis, which includes peritoneal dialysis and home hemodialysis, is an effective way of reducing costs related to renal replacement therapy, reducing central venous catheter usage and in many cases improving the clinical and psychosocial aspects of patients' health...
May 2020: Advances in Chronic Kidney Disease
Khaled Boubes, Aisha Shaikh, Zygimantas Alsauskas, Amy Dwyer
Tunneled dialysis catheters remain the most common vascular access used to initiate hemodialysis. Unfortunately, their use is associated with higher morbidity and mortality when compared with arteriovenous fistulae or grafts. Different types of catheters with different designs and material properties function differently. Additional devices and medications can be used to decrease the rates of infection and thrombosis. The current available tunneled dialysis catheters remain far from the desired goal and innovation in the field of dialysis vascular access remains in dire need...
May 2020: Advances in Chronic Kidney Disease
Tushar J Vachharajani, Mohamed Hassanein, Aimen Liaqat, Nabil Haddad
Chronic kidney disease (CKD) is a major noncommunicable disorder and has become the 9th leading cause of death in the United States. Most patients with CKD in the United States choose hemodialysis as their treatment of choice. A functioning arteriovenous access is essential to reduce dependence on central venous catheters. An arteriovenous fistula (AVF), though the preferred access, has a major limitation with a high primary maturation failure rate. A functioning AVF requires well-preserved vessels, both arteries and veins, along with an acceptable cardiac pump function...
May 2020: Advances in Chronic Kidney Disease
Aditya Safaya, Kalyani Bhuta, Heena Rajdeo
OBJECTIVE: Renal dysfunction, requiring renal replacement therapy (RRT) is commonly encountered in patients with left ventricular assist devices (LVAD). Continuous flow LVAD (CFLVAD) is the most widely used device. Non-pulsatile blood flow begets special hemodynamic changes. This poses a unique challenge in choosing a long-term dialysis access for patients with CFLVAD where life expectancy is limited. METHODS: Sixty-one year old man with an implanted CFLVAD and renal dysfunction receiving intermittent RRT through a non-tunneled dialysis catheter had progressed to dialysis dependent renal failure...
September 2, 2020: Annals of Vascular Surgery
Ricardo Portiolli Franco, Ciro Bruno Silveira Costa, Clayton Santos Sousa, Anderson Tavares Rodrigues, Precil Diego Miranda de Menezes Neves, Domingos Candiota Chula
Vascular accesses for hemodialysis are considered the patient's lifeline and their maintenance is essential for treatment continuity. Following the example of institutions in other countries affected by the Covid-19 pandemic, the Brazilian Society of Nephrology developed these guidelines for healthcare services, elaborating on the importance of carrying out procedures for the preparation and preservation of vascular accesses. Creating definitive accesses for hemodialysis, grafts and arteriovenous fistulas are non-elective procedures, as well as the transition from the use of non-tunneled catheters to tunneled catheters, which cause less morbidity...
August 26, 2020: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Ákos Pethő, Mihály Tapolyai, Timea Szakács-Pál, Petronella Orosz, László Dézsi, László Rosivall
INTRODUCTION: The implantation of acute or chronic vascular accesses for hemodialysis (HD) in end-stage kidney disease patients is a critical skill procedure for nephrologists, with an impact on short- and long-term outcomes of the modality and patient survival. Placement circumstances, however, may depend on the availability of technological support and will likely vary across the world. MATERIALS AND METHODS: We retrospectively reviewed our local experience with ultrasound-guided tunneled dialysis catheter (TDC) insertions but without access to fluoroscopic guidance...
September 1, 2020: Clinical Nephrology
B V Baykov, A B Zulkarnaev, A G Yankovoy, E V Strugailo
Aneurysmal transformation of arteriovenous fistula (AVF) is a common complication and associated with increased risk of arrosive bleeding. Ligation of fistulous vein is conventional surgery for bleeding. This is followed by AVF malfunction and need for implantation of central venous catheter. We report reconstructive surgery and maintaining the function of AVF in a patient with aneurysmal transformation of AVF after arrosive bleeding. Reconstructive vascular surgery can significantly extend the period of patent AVF for hemodialysis...
2020: Khirurgiia
Elif Balikci, Bengi Yilmaz, Aydin Tahmasebifar, Erkan Türker Baran, Ekrem Kara
Insertion of a central venous catheter is one of the most common invasive procedures applied in hemodialysis therapy for end-stage renal disease. The most important complication of a central venous catheter is catheter-related infections that increase hospitalization and duration of intensive care unit stay, cost of treatment, mortality, and morbidity rates. Pathogenic microorganisms, such as, bacteria and fungi, enter the body from the catheter insertion site and the surface of the catheter can become colonized...
August 31, 2020: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Mridula Muthe, Anagha Joshi, Vikrant Firke
Hemodialysis catheter insertion is a common practice for the patients with renal failure. There are several complications associated with hemodialysis catheter insertion such as infection, catheter thrombosis, malposition, or vein stenosis; however, loss of guidewire during catheter insertion with its migration is a rare complication. We report the case of a 75-year-old male with forgotten displaced guidewire which came out spontaneously from the skull in the occipital region, three years after the hemodialysis...
June 2020: Indian Journal of Critical Care Medicine
Teresa Moreno-Sanchez, Manuela Moreno-Ramirez
INTRODUCTION: Retrospective observational study to evaluate the technique of cannulation guided by ultrasound of the left internal jugular vein (LIJV) using a lateral oblique axis (LOAX) approach with variable angulation in the placement of tunneled central venous catheters (CVC) for hemodialysis. METHODS: Seventy-one patients with 77 LIJV vascular accesses aged 16 or older who needed CVC for hemodialysis were evaluated. The catheters were inserted, guided by LOAX ultrasound with variable angulation, depending on the angulation of the left brachiocephalic trunk...
August 27, 2020: Hemodialysis International
Lihua Wang, Fang Wei, Haiyan Chen, Lan Jia, Bo Li, Aili Jiang
BACKGROUND AND OBJECTIVES: For patients who rely on a tunneled cuffed catheter, the internal jugular vein is the preferred site of insertion. A few studies have suggested that the posterior approach for central lines is equivalent or better in comparison to the conventional central approach. However, there have been fewer studies examining tunneled cuffed catheter insertion using the posterior approach. We have performed many posterior insertions of tunneled cuffed catheters in our practice, and because the technique has not yet been comprehensively studied for long-term use, we performed a retrospective study to evaluate the safety and efficacy of posterior approach for tunneled cuffed catheter in maintained hemodialysis patients...
August 23, 2020: Journal of Vascular Access
Ali AlSahow, Bassam AlHelal, Anas Alyousef, Ahmad AlQallaf, Ayman Marzouq, Hani Nawar, George Fanous, Mohammed Abdelaty, Yousif Bahbahani, Heba AlRajab, Aisha AlTerkait, Hamad Ali
The total number of end-stage kidney disease patients treated with dialysis in 2019 in Kuwait was 2230, with a 6% increase from the year before. Dialysis prevalence was 465 per million population (PMP) and dialysis incidence was100 PMP. Kuwaiti nationals represented 70% of the dialysis population and males represented 52%. Of the same population, 59% had diabetes. Hepatitis C virus affected <4% and hepatitis B virus affected <2% of the dialysis population. The annual mortality rate was stable at around 12%...
July 2020: Saudi Journal of Kidney Diseases and Transplantation
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