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
Jeffrey Hull, John Deitrick, Karey Groome
PURPOSE: To prospectively evaluate the maturation of the endovascular arteriovenous fistula system (EndoAVF) for 2-needle cannulation (2NC). MATERIALS AND METHODS: From October 2018 to June 2019, evaluation of 123 patients resulted in 95 arteriovenous fistulae, a rate of 63% (60 of 95) EndoAVF, and 37% (35 of 60) fistulae treated surgically. At 4 weeks, EndoAVF was not suitable for 2NC (defined as a palpable target vein [TV], 500 mL/min flow volume, and 5-mm diameter) underwent maturation procedures...
September 2020: Journal of Vascular and Interventional Radiology: JVIR
Yuya Adachi, Masanori Yamamoto, Tetsuro Shimura, Ryo Yamaguchi, Ai Kagase, Takahiro Tokuda, Satoshi Tsujimoto, Yutaka Koyama, Toshiaki Otsuka, Fumiaki Yashima, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Yusuke Watanabe, Kentaro Hayashida
Data regarding the longitudinal effect of catheter procedure-related acute kidney injury (AKI) on clinical outcomes are limited. This study aimed to assess the late adverse cardiorenal events of AKI following transcatheter aortic valve implantation (TAVI). A total of 2,518 patients who underwent TAVI, excluding in-hospital deaths, were enrolled from the Japanese multicenter registry. The definition of AKI was determined using the Valve Academic Research Consortium-2 criteria. The incidence, predictors, major adverse renal and cardiac events (MARCE), and all-cause mortality of AKI were evaluated...
July 24, 2020: American Journal of Cardiology
Arunraj Navaratnarajah, Damien R Ashby
Central venous stenosis is a well-recognized complication of central venous catheter use in hemodialysis patients, which may present with significant swelling of the upper limbs, neck, and face. Here, we describe a renal transplant recipient previously on hemodialysis, who underwent endovascular intervention for central venous stenosis after presenting with facial swelling and exertional dyspnoea. His symptoms continued to progress, however, until the underlying thyroid pathology was recognized. Ruling out the possible mimics of central venous stenosis is important in preventing unnecessary intervention...
August 12, 2020: Hemodialysis International
Kajan Raj Shrestha, Dinesh Gurung, Uttam Krishna Shrestha
INTRODUCTION: Arteriovenous fistula is the most common vascular access for patients requiring hemodialysis, but it is not always possible or practical hence cuffed tunneled dialysis catheter comes into play. The aim of the study was to determine the outcome of cuffed tunneled dialysis catheter used for hemodialysis at a teaching hospital. METHODS: A descriptive cross-sectional study was conducted between January 2014 and December 2019 on 103 chronic dialysis patients with end-stage renal disease presenting to a tertiary care hospital...
June 30, 2020: JNMA; Journal of the Nepal Medical Association
Kentaro Oshiro, Go Kanzaki, Yukio Maruyama, Takashi Yokoo
No abstract text is available yet for this article.
August 12, 2020: Internal Medicine
Charmaine E Lok, Thomas S Huber, Timmy Lee, Surendra Shenoy, Alexander S Yevzlin, Kenneth Abreo, Michael Allon, Arif Asif, Brad C Astor, Marc H Glickman, Janet Graham, Louise M Moist, Dheeraj K Rajan, Cynthia Roberts, Tushar J Vachharajani, Rudolph P Valentini
The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for hemodialysis vascular access since 1996. Since the last update in 2006, there has been a great accumulation of new evidence and sophistication in the guidelines process. The 2019 update to the KDOQI Clinical Practice Guideline for Vascular Access is a comprehensive document intended to assist multidisciplinary practitioners care for chronic kidney disease patients and their vascular access...
April 2020: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Maite Rivera Gorrín, R Haridian Sosa Barrios, Carlos Ruiz-Zorrilla López, Juan Manuel Fernández, Silvia Marrero Robayna, José Ibeas López, Mercedes Salgueira Lazo, María Jesús Moyano Franco, Carlos Narváez Mejía, Manuel Ceballos Guerrero, Jordi Calabia Martínez, Antonio Luis García Herrera, Ramón Roca Tey, Vicente Paraíso Cuevas, José Luis Merino Rivas, Iyad Abuward Abu-Sharkh, Àngels Betriu Bars
Ultrasound is an essential tool in the management of the nephrological patient allowing the diagnosis, monitoring and performance of kidney intervention. However, the usefulness of ultrasound in the hands of the nephrologist is not limited exclusively to the ultrasound study of the kidney. By ultrasound, the nephrologist can also optimize the management of arteriovenous fistula for hemodialysis, measure cardiovascular risk (mean intimate thickness), implant central catheters for ultrasound-guided HD, as well as the patient's volemia using basic cardiac ultrasound, ultrasound of the cava inferior vein and lungs...
August 6, 2020: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Ken J Park, Jose G Benuzillo, Erin Keast, Micah L Thorp, David M Mosen, Eric S Johnson
BACKGROUND AND OBJECTIVES: Optimal timing of arteriovenous fistula placement in chronic kidney disease remains difficult and contributes to high central venous catheter use at initial hemodialysis. We tested whether a prediction model for progression to renal replacement therapy developed at Kaiser Permanente Northwest may help guide decisions about timing of referral for arteriovenous fistula placement. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: A total of 205 chronic kidney disease stage 4 patients followed by nephrology referred for arteriovenous fistula placement were followed for up to 2 years...
August 8, 2020: Journal of Vascular Access
Ying-Sheng Li, Pin-Chao Feng, Po-Jen Ko, Wen-Cheng Wei, Sheng-Yueh Yu, Tsung-Chi Kao, Chun-Hsien Hsin, Ta-Wei Su
AIMS: Surgical resection could be an eradication treatment for patients with infected hemodialysis arteriovenous grafts (AVGs). This study aimed to investigate the outcomes of three surgical methods, including total resection, sub-total resection, and revision. METHODS: The patients who underwent surgical excision of infected AVGs performed at a single center from August 2012 to March 2019 were retrospectively analyzed. The following three surgical methods were used in our study: revision, sub-total resection, and total resection...
August 5, 2020: Annals of Vascular Surgery
David G Owen, Diana C de Oliveira, Shuang Qian, Naomi C Green, Duncan E T Shepherd, Daniel M Espino
Hemodialysis catheters are used to support blood filtration, yet there are multiple fundamentally different approaches to catheter tip design with no clear optimal solution. Side-holes have been shown to increase flow rates and decrease recirculation but have been associated with clotting/increased infection rates. This study investigates the impact of changing the shape, size and number of side-holes on a simple symmetric tip catheter by evaluating the velocity, shear stress and shear rate of inflowing blood...
2020: PloS One
Saraschandra Vallabhajosyula, Gregory W Barsness, Joerg Herrmann, Nandan S Anavekar, Rajiv Gulati, Abhiram Prasad
There are limited data on the incidence of complications and in-hospital outcomes, in patients with Takotsubo cardiomyopathy (TC), as compared with acute myocardial infarction (AMI). From 2007 to 2014, a retrospective cohort of TC was compared with AMI using the National Inpatient Sample database. Complications were classified as acute heart failure, ventricular arrhythmic, cardiac arrest, high-grade atrioventricular block, mechanical, vascular/access, pericardial, stroke, and acute kidney injury. Temporal trends, clinical characteristics, and in-hospital outcomes were compared...
July 13, 2020: American Journal of Cardiology
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
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