Catheter tip malposition after percutaneous placement of tunneled hemodialysis catheters

Abstract The percutaneous catheterization of central veins is increasingly used in nephrological practice as a temporary or permanent vascular access. The aim of our study was to present and to analyze episodes of catheter tip malposition during percutaneous tunneled hemodialysis catheter insertion in the large, unselected group of patients. All patients who underwent the procedure of catheter insertion in our department during year 2012 were analyzed retrospectively. One hundred four tunneled hemodialysis catheters were inserted in 101 patients. In 58 patients, the catheter was inserted at the initiation of hemodialysis therapy as the first access and in 46 the catheter was placed because of the failure of the existing one. In 68 patients, the catheter was inserted into the right internal jugular vein and in 20 patients into the left internal jugular vein (LIJV). Subclavian veins were used in five cases and femoral veins in 11 cases. Malposition of the catheter tips occurred in six patients. In all cases, the LIJV was cannulated. In two cases, the catheter tip malposition was in the right innominate vein and in four cases in the azygos vein. Our data demonstrate that with the blind insertion of tunneled hemodialysis catheters, the risk of catheter tip malposition is significantly higher with the left side insertion. As catheter insertion through the LIJV holds very high (30%) risk of the tip malposition, it should always be performed under the fluoroscopic control.
Source: Hemodialysis International - Category: Hematology Authors: Tags: Original Article Source Type: research

Related Links:

Constipation is common in patients with end-stage kidney disease. Nondrug strategies to manage constipation are challenging because of dietary potassium, phosphate, and fluid restrictions. Nuts are a high-fiber food but are excluded from the diet because of the high potassium and phosphate content. The aim of this study was to examine the safety and efficacy of using nuts to improve constipation in adults undertaking hemodialysis (HD).
Source: Journal of Renal Nutrition - Category: Urology & Nephrology Authors: Tags: Original Research Source Type: research
Nature Reviews Nephrology, Published online: 27 January 2020; doi:10.1038/s41581-020-0251-3The KALM-1 randomized double-blind placebo-controlled phase III trial showed that intravenous difelikefalin, a selective κ-opioid receptor agonist, significantly reduces itch intensity in haemodialysis patients with uraemic pruritus. However, 49% of difelikefalin-treated patients showed no improvement. In light of the increasing number of patients with end-stage renal disease, additional treatments are sorely needed.
Source: Nature Reviews Nephrology - Category: Urology & Nephrology Authors: Source Type: research
It was reported elevated serum uric acid (SUA) has been associated with vascular cognitive impairment (CI) in the elderly. However, its relationship with cognitive function in the elderly patients receiving hemodialysis (HD) has not been elucidated. Herein, we enrolled 180 elderly HD subjects from two hospitals. Their cognitive function domains were evaluated using MMSE scores at the beginning of the trial, and their demographic and clinical characteristics were collected. We found that the elevated SUA maybe contributes to cognitive impairment in the elderly HD patients. AbstractBackgroundElevated serum uric acid (SUA) ha...
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
AbstractSpontaneous native kidney rupture (SNKR) is a rare occurrence, commonly associated with underlying renal tumors or acquired renal cystic disease in both the kidney transplant (KT) and non-KT populations. Herein, we present a 65-year-old African American man who experienced a non-malignant SNKR 6  days after a deceased donor KT and underwent emergent native nephrectomy. The patient’s hospital course was complicated by thrombocytopenia and refractory hypertension. He experienced delayed graft function and was maintained on hemodialysis until post-operative day 30. This case demonstrates an unusual presenta...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
We report the case of a 71-year-old Japanese woman who complained of hemiparesis. She required maintenance hemodialysis therapy with a background of ADPKD. Cerebral infarction was initially diagnosed by excluding intracranial hemorrhage and aneurysm rupture that are recognized as common complications of ADPKD and thereby anticoagulation therapy was initiated. However, the patient was suspected as having painless aortic dissection because a chest X-ray examination showed expanded upper mediastinum. Sequential vascular imagings revealed dissection of the aorta, originating from brachiocephalic trunk to the right common carot...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
AbstractBackgroundSerum anion gap (AG) has recently been proven to represent a biomarker for predicting prognosis in patients with end-stage renal disease (ESRD). However, whether change in AG ( ΔAG) at the time of starting hemodialysis predicts mortality after starting hemodialysis in elderly patients with ESRD remains unknown.MethodsThis retrospective cohort investigated the association between ΔAG and mortality after starting hemodialysis in the elderly. The cohort comprised patients ≥ 75 years old who started hemodialysis for ESRD at National Center for Global Health and Medicine betwe...
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
CONCLUSION: Dialysis was not an inhibitory factor affecting outcomes during subacute rehabilitation in patients with stroke. Rehabilitation should be considered for patients with subacute stroke requiring haemodialysis, in order to provide every opportunity to achieve adequate functional outcomes. PMID: 31974589 [PubMed - as supplied by publisher]
Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
Publication date: Available online 25 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Zhi-Huang Qiu, Liang-Wan Chen, Lian-Ming Liao, Jun Xiao, Xiao-Fu Dai, Guan-Hua Fang, Liang-Liang Yan, Qing-Song Wu, Quan-Fang LuoAbstractBackgroundThe efficacy of hemiarch replacement combined with a modified triple-branched stent graft in Debakey type I aortic dissection remains to be confirmed.MethodsFrom January 2016 to December 2017, 167 patients with acute Debakey type I aortic dissection underwent hemiarch replacement combined with a modified triple-branched stent graft. The clinical and imaging data were retrospectivel...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Elevated serum lipoprotein(a) [Lp(a)] level is an independent risk factor for atherosclerotic diseases in the general population and hemodialysis (HD) patients. However, the association between Lp(a) levels and mortality has received little attention in peritoneal dialysis (PD) patients.
Source: Journal of Clinical Lipidology - Category: Lipidology Authors: Tags: Original Research Source Type: research
Abstract Since the amount of contrast media during percutaneous coronary intervention (PCI) is closely related to the exacerbation of renal function, it should be important to reduce the dose of contrast media during PCI. The purpose of this retrospective study was to evaluate the association of less-contrast media with clinical factors in elective PCI. A total of 709 patients were divided into the less-contrast media group (n = 142) and the conventional-contrast media group (n = 567) according to the quintile of total contrast volume. Univariate and multivariate logistic regression analyses w...
Source: Heart and Vessels - Category: Cardiology Source Type: research
More News: Dialysis | Eyes | Hematology | Hemodialysis | Study | Urology & Nephrology