Vascular Access Placement Order and Outcomes in Hemodialysis Patients: A Longitudinal Study
Conclusions:HD vascular access outcomes differ based on the sequence of placement. In spite of frequent AVA placements, only half of patients effectively achieved a “permanent” vascular access and used an AVA for the majority of HD treatments.Am J Nephrol 2017;46:268-275
Conclusion: High ScvO2 variability during dialysis is associated with increased all-cause mortality.Blood Purif
ConclusionsGiven our decision-making threshold, both open and endovascular procedures are associated with relatively low morbidity and high efficacy for treatment of central venous occlusion in both symptomatic VTOS and AV access-associated subclavian vein disease. Restenosis is common in patients with a patent ipsilateral hemodialysis access.
Authors: Piccoli GB, Cabiddu G, Gallieni M Abstract Pregnancy in dialysis patients is a rare but important event that challenges our knowledge and demands re-thinking many aspects of our practice, including vascular access. This editorial briefly discusses some open questions on vascular access in this situation that challenge the motto 'fistula first' and underline the need for personalised approaches. Information on vascular access in pregnant women is scant. Different approaches may be considered between women on dialysis already on a well-functioning tunnelled catheter and newly placed catheters: while a tunnel...
Uninsured patients who start in-center hemodialysis with a central venous catheter are less likely than those already on Medicare or Medicaid to obtain arteriovenous fistulas (AVF) or grafts (AVG) by their fourth month of dialysis, when they become Medicare eligible, according to a new study.Reuters Health Information
CONCLUSIONS: Insurance-related disparities in the use of arteriovenous fistulas and grafts persist through the fourth month of dialysis, may not fully correct after all patients obtain Medicare coverage, and may lead to more frequent vascular access infections. PMID: 30385594 [PubMed - as supplied by publisher]
Abstract BACKGROUND: Noncuffed catheters (NCC) are often used for incident hemodialysis (HD) patients without a functional vascular access. This, unfortunately results in frequent catheter-related complications such as infection, malfunction, vessel stenosis, and obstruction, leading to loss of permanent central venous access with superior vena cava obstruction. It is important to preserve central vein patency by reducing the number of internal jugular catheter insertions for incident HD patients with a functional vascular access. We sought to achieve this by introducing in-patient intermittent peritoneal dialysis...
Authors: Elbarbary AH Abstract OBJECTIVE:: Lipectomy is an acceptable method of cephalic vein superficialization in hemodialysis arteriovenous fistula. However, limiting it to be a secondary procedure may prolong time between fistula creation and successful cannulation posing more risk of central venous catheter use. AIM:: The aim of this study is to evaluate primary surgical lipectomy performed at the time of arteriovenous fistula creation in comparison with secondary lipectomy. PATIENTS AND METHODS:: Between June 2015 and January 2017, 59 adult end-stage renal disease patients were allocated non-randomly ...
ConclusionsEndovascular therapy (PTA) with or without stenting for central venous stenosis is safe, with low rates of technical failure. Multiple additional interventions are the rule and long-term patency rate is not very good.
CONCLUSION:: Dynamic ultrasound-based visualization of microbubbles in the right atrium is a highly accurate method to detect percutaneous implantation of large-lumen, tunneled, central venous catheters without the need for fluoroscopic guidance technology. Future research should further develop and confirm these initial findings. PMID: 30354909 [PubMed - as supplied by publisher]
CONCLUSIONS: Compared with patients with nonoptimal starts, patients with optimal ESRD starts have lower morbidity and mortality and less use of inpatient and outpatient care. Late-stage chronic kidney disease and ESRD care in an integrated system may be associated with greater benefits than those previously reported in the literature. PMID: 30325191 [PubMed - in process]