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
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
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: Journal of the International Pediatric Nephrology Association
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
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