Features of high flow access in the elderly.
CONCLUSION: Elderly patients who underwent blood flow suppression procedures or subcutaneous fixation of the superficial artery exhibited lower flow volume, and the effects of high flow access in elderly patients depend on the nature of vascular changes. Ultimately, the underlying conditions and hemodynamics of each patient must be determined on an individual basis. PMID: 31032728 [PubMed - in process]
Jeong et al. reported the results of a randomized controlled trial in patients on hemodialysis in which intradialytic protein supplementation, with or without exercise, failed to show any beneficial effect on physical function, vascular health, and nutritional markers. These data provide an opportunity to reconsider the appropriate strategy to gain the most benefit from these otherwise proven interventions, that is, prescribing the right intervention for the right patient, at the right dose and at the right time.
Although control of chronic glycemia in the population with diabetes and end-stage renal disease (ESRD) has been extensively studied in recent years, the unique problems of short-term glycemic management in acutely ill patients undergoing dialysis have received little attention. Bally et al. evaluated the role of a “closed-loop” (glucose sensor/algorithm tablet device/insulin pump) system in a cohort of hospitalized patients with type 2 diabetes receiving hemodialysis. Compared with usual care, the intervention group had superior glycemic control without increased hypoglycemic events.
Arteriovenous fistulas for patients undergoing hemodialysis (HD) are at high risk of stenosis. Despite conventional balloon angioplasty (CBA), restenosis rates are high. The use of a drug-coated balloon (DCB) may offer an alternative to reduce restenosis.
Current arteriovenous grafts (AVGs) have unacceptably high failure rates. This issue led to the development of tissue-engineered vascular grafts in an attempt to mimic a native blood vessel. We hypothesized that a novel synthetic vascular graft could be developed using electrospinning technology that functions as scaffolding for cell ingrowth, thereby providing the added natural protection of native cells against thrombosis and infection. The resulting graft would also maintain the strength, kink resistance, and safety with cannulation that standard synthetic AVGs provide.
Arteriovenous fistulas (AVFs) are the most common access created for hemodialysis, but approximately 40% fail to mature, suggesting a clinical need. In a mouse model, reduced Akt1 expression reduces AVF wall thickness and diameter. We hypothesized that inhibition of Akt1-mTORC1 axis alters venous remodeling associated with failure of AVF.
The radiocephalic arteriovenous fistula (AVF) is the preferred standard for patients needing primary hemodialysis access creation. In patients who lack suitable superficial veins in the distal upper extremity, proximal native vessels or synthetic grafts are often used. However, proximal primary access creation results in loss of vascular territory for future interventions, and grafts and proximal vessels have been shown to be inferior starting points because of higher risk of infection, thrombosis, and steal syndrome.
Staphylococcal scalded skin syndrome (SSSS) is an exfoliative skin syndrome that occurs as a reaction to an exotoxin released by Staphylococcus aureus, and most commonly occurs in children and adults with renal failure or immunocompromised. Patients can have variation of severity, from localized blisters to generalized skin exfoliation involving all body surfaces. SSSS can be life-threating and should be diagnosed and treated promptly. This is a case of 51 y/o woman with hypertension, type 2 diabetes mellitus, cardiomyopathy, and renal failure for which has been receiving hemodialysis (HD) for the past 4 years that present...
Conditions: Chronic Kidney Disease; End Stage Renal Disease; Hemodialysis; Peritoneal Dialysis Interventions: Other: Comprehensive Pre-ESRD Patient Education (CPE); Other: Provision of the freely available resources for Kidney Disease Education Sponsor: VA Office of Research and Development Not yet recruiting
Conditions: Kidney Diseases; End Stage Renal Disease; Hemodialysis Complication Intervention: Procedure: blood sample Sponsor: Universitair Ziekenhuis Brussel Completed
We present a patient who simultaneously developed psychosis and acute renal failure associated with excessive energy drink consumption. The patient required haemodialysis, and his psychosis resolved on cessation of energy drinks and a brief course of antipsychotic medication. We perform a review of similar cases where excessive caffeinated energy drink consumption has been linked to psychosis or acute renal failure. To our knowledge, this is the first case report describing both renal failure and psychosis occurring simultaneously in a patient. Recognising the spectrum of disorders associated with excessive energy drink co...