scholarly journals Severe venous neointimal hyperplasia prior to dialysis access surgery

2011 ◽  
Vol 26 (7) ◽  
pp. 2264-2270 ◽  
Author(s):  
T. Lee ◽  
V. Chauhan ◽  
M. Krishnamoorthy ◽  
Y. Wang ◽  
L. Arend ◽  
...  
Author(s):  
George P. Noon ◽  
H. David Short

Author(s):  
Ingemar Davidson ◽  
Matthias K. Widmer ◽  
Billy Nolen ◽  
John Ross ◽  
Douglas P. Slakey

Vascular ◽  
2017 ◽  
Vol 26 (1) ◽  
pp. 75-79
Author(s):  
Edvard Skripochnik ◽  
David J O’Connor ◽  
Eric B Trestman ◽  
Evan C Lipsitz ◽  
Larry A Scher

Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960–2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access


2002 ◽  
Vol 184 (6) ◽  
pp. 568-572 ◽  
Author(s):  
Matthew C Parmley ◽  
Thomas A Broughan ◽  
William C Jennings

2016 ◽  
Vol 45 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Randall C. Gale ◽  
Doreen Kehoe ◽  
Yiming Z. Lit ◽  
Steven M. Asch ◽  
Manjula Kurella Tamura

Background and Objectives: Preemptive placement of permanent dialysis access is recommended in order to reduce the morbidity associated with central venous catheters. We assessed the effect of a dialysis access coordinator on preemptive access placement in veterans who are at high risk for end-stage renal disease (ESRD). Design, Setting, Participants, and Measurements: Pre-post evaluation of a dialysis access coordinator in the nephrology clinics of the Veterans Affairs Palo Alto. The access coordinator streamlined access referrals, prioritized surgical waiting lists and addressed patient barriers. We compared the frequency of preemptive access referral, surgery, and use for dialysis during the intervention period, July 1, 2013 to May 31, 2016, to a pre-intervention period, January 1, 2011 to December 31, 2013, among all patients with a predicted 1-year risk for ESRD ≥20%. Results: There were 156 patients in the historical cohort and 131 in the intervention cohort. The mean age was 69.9 ± 11.6 years and the mean estimated glomerular filtration rate was 14.5 ± 5.7 ml/min/1.73 m2. The intervention was associated with an 11.8% increase in access referral (p value = 0.03), and a 9.4% increase in completed access surgery (p value = 0.05). Increases in permanent access at the start of dialysis (15.2%), and functional permanent access at the start of dialysis (12.4%) did not reach statistical significance. Among patients who received access surgery, there was no significant difference in the prevalence of unused access. Conclusions: Implementation of an access coordinator was associated with a modest increase in preemptive access placement among patients who are at high risk for ESRD without increasing the prevalence of unused access.


2019 ◽  
Vol 5 (02) ◽  
pp. 37-41
Author(s):  
Prapti Rath ◽  
Archana Shivashankar ◽  
Luv Luthra ◽  
Nivedita Mitta

AbstractThe incidence of chronic kidney disease (CKD) is alarmingly high in Indian population with a steep rise in end-stage renal disease patients requiring dialysis access. The preexisting comorbidities associated with high morbidity further necessitate an anesthetic plan which provides benefits intraoperatively as well postoperatively. Different anesthesia techniques can be employed in CKD patients which are associated with complications. The aim of this review is to study the role and benefits of regional anesthesia in CKD patients.


2018 ◽  
Vol 49 ◽  
pp. 277-280
Author(s):  
Kelsey Gray ◽  
Abraham Korn ◽  
Joshua Zane ◽  
Hamid Alipour ◽  
Amy Kaji ◽  
...  

PRILOZI ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 43-49
Author(s):  
Vladimir Pushevski ◽  
Petar Dejanov ◽  
Vesna Gerasimovska ◽  
Gordana Petrushevska ◽  
Angel Oncevski ◽  
...  

Abstract Background: Hemodialysis as an efficient therapy for advanced CKD is the most used treatment modality all over the world. Even though primary AVF is widely accepted as a best permanent vascular access in hemodialysis patients, up to 60% of all fistulas fail to mature. The pathogenesis of early fistula failure is not very well understood. Many general and local factors are involved: patient′s age, sex, primary renal disease, small vessel′s diameter, presence of accessory veins, prior venipunctures, surgical skill, genetics, etc. Histological investigations have confirmed the neointimal venous hyperplasia as a major pathological finding in stenotic lesions of AVF failure, due to local inflammation, oxidative stress and migration and proliferation of myofibroblasts, fibroblasts and endothelial cells. Materials and methods: A total of 89 patients with stadium 4-5 of CKD are involved in the study. A typical radio-cephalic AVF is created in all patients. Part of the fistula vein was taken for histological, immunohistochemical (Vimentin, TGF β and KI67) and morphometric analysis. Appriopriate statistical method was applied. Results: Up to 80% of the patients showed some degree of endothelial changes at the time of creation of AVF, among them 19 pts with substantial intimal hyperplasia, 51 with medial hypertrophy and 19 pts with normal histology. Almost two thirds of the patients did not have expression of TGFβ. More than 95% had some expression of Vimentin. None of the patients had expression of the marker KI 67. Conclusion: Medial hypertrophy is predominant preexisting pathohistological lesion prior the AVF creation, despite the presence of neointimal hyperplasia. The absence of TGFβ expression in majority of our patients could suggest that inflammation and oxidative stress are developing later, after vascular access surgery. The dominant cells within the stenosis in the veins are myofibroblasts. Their increased presence maybe a reason why some patients are prone to developing venous endothelial changes as a results of exaggerated vascular endothelial response to the effect of uremia, hypertension and other insults.


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