Safety of Low Volume Iodinated Contrast Administration for Arteriovenous Fistula Intervention in Chronic Kidney Disease Stage 4 or 5 Utilizing a Bicarbonate Prophylaxis Strategy

2010 ◽  
Vol 23 (6) ◽  
pp. 638-642 ◽  
Author(s):  
Elizabeth Eisenhart ◽  
Scott Benson ◽  
Patricia Lacombe ◽  
Jonathan Himmelfarb ◽  
Robert Zimmerman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arteriovenous Fistula ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Contrast Administration ◽  
Iodinated Contrast ◽  
Stage 4 ◽  
Low Volume ◽  
Prophylaxis Strategy

Predicted risk of renal replacement therapy at arteriovenous fistula referral in chronic kidney disease

2020 ◽  
pp. 112972982094786
Author(s):  
Ken J Park ◽  
Jose G Benuzillo ◽  
Erin Keast ◽  
Micah L Thorp ◽  
David M Mosen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Arteriovenous Fistula ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Kaiser Permanente ◽  
Stage 4 ◽  
Glomerular Filtrate

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. Patients were censored if they died or discontinued Kaiser Permanente Northwest coverage. Survival analyses were performed for overall progression to renal replacement therapy divided by quartiles based on 2-year risk for renal replacement therapy and estimated glomerular filtrate rate at time of referral. Results: By 2 years, 60% progressed to renal replacement therapy and 11% had died. 80% in the highest risk versus 36% in the lowest risk quartile progressed to renal replacement therapy (predicted risk 84% vs 17%). 75% in the lowest estimated glomerular filtrate rate versus 56% in the highest estimated glomerular filtrate rate quartile progressed to renal replacement therapy (mean estimated glomerular filtrate rate 13 mL/min vs 21 mL/min). The hazard ratio was significantly higher for each consecutive higher renal replacement therapy quartile risk while for estimated glomerular filtrate rate, the hazard ratio was only significantly higher for the lowest compared to the highest quartile. The extreme quartile risk ratio was higher for 2-year risk for renal replacement therapy compared to estimated glomerular filtrate rate (4.0 vs 2.4). Conclusion: In patients with chronic kidney disease stage 4 referred for arteriovenous fistula placement, 2-year renal replacement therapy risk better discriminated progression to renal replacement therapy compared to estimated glomerular filtrate rate at time of referral.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

scholarly journals Primary Failure of the Arteriovenous Fistula in Patients with Chronic Kidney Disease Stage 4/5

2019 ◽  
Vol 7 (11) ◽  
pp. 1782-1787 ◽  
Author(s):  
Nikola Gjorgjievski ◽  
Pavlina Dzekova-Vidimliski ◽  
Vesna Gerasimovska ◽  
Svetlana Pavleska-Kuzmanovska ◽  
Julija Gjorgievska ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Disease Stage ◽  
Arteriovenous Fistulae ◽  
Primary Renal Disease ◽  
Stage 4 ◽  
Ckd Stage ◽  
Male Patients

BACKGROUND: An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a “gate of life” for the patients on hemodialysis. AIM: The study aimed to analyze the predictors for primary failure of AVF such as gender, age, number and location of AVF, and primary renal disease in patients with chronic kidney disease (CKD) stage 4/5.MATERIAL AND METHODS: The medical records of 178 created arteriovenous fistulae in patients with CKD stage 4/5, were retrospectively studied. Primary failure of AVF was defined as thrombosis or inability for cannulation of AVF within 3 months. Adequate maturation of AVF was defined as successful cannulation of AVF treatment and blood flow of > 600 ml/min.RESULTS: The mean age of the patients was 59.75 ± 14.65 years, and 65.16% (116/178) were men. Adequate maturation of AVF was achieved in 83.71% (149/178). Primary failure of AVF occurred in 16.29% (29/178) of the created fistulae, while 10.11% (18/178) had early thrombosis. The distal arteriovenous fistulae were significantly more frequently created in male patients (51 vs 18; p = 0.015). The female patients were significantly older than the male patients (63.27 vs 57.86 years; p = 0.018). CONCLUSION: Male gender was associated with better maturation of AVF. The age, number and location of AVF, and primary renal disease in patients with CKD stage 4/5 were not associated with primary failure of AVF.

scholarly journals Hubungan Gagal Ginjal Kronik Tingkat 4 Dan 5 Dengan Kejadian Dislipidemia Pada Pasien Gagal Ginjal Kronik Di Rumah Sakit Umum Pusat Fatmawati Periode Tahun 2016

2018 ◽  
Vol 12 (2) ◽  
Author(s):  
Dimas Farhan Wibawanto ◽  
Salman Paris ◽  
Maria Selvester Thadeus
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Density Lipoprotein ◽  
Low Density Lipoprotein ◽  
Chronic Kidney Disease Stage ◽  
Density Lipoprotein ◽  
Disease Stage ◽  
Low Density ◽  
Stage 4 ◽  
Relationship Of

Dyslipidemia is a common complication of chronic kidney disease. Dyslipidemia itself is a common risk for a cardiovascular disease, which is the leading cause of death in chronic kidney disease. This study aims to identify the relationship of chronic kidney disease stage 4 and 5 with the incidence of dyslipidemia at Fatmawati General Hospital in the period of 2016. Design cross-sectional with simple random sampling technique. Data were collected by looking at the patient's medical records. Respondents are 80 people. The study population were all patients diagnosed with chronic kidney disease at Fatmawati Central General Hospital in 2016. The results showed that most chronic kidney disease stage 4 has normal level of low density lipoprotein as many 22 people (73.33%) while at stage 5 most have high level of low density lipoprotein high as many 36 people (72%). High density lipoprotein obtained in patients with chronic kidney disease stage 4 mostly had normal level as many 20 people (66.67%) for stage 5 mostly had low level as many 33 people (66%). Mean lipid values of triglyceride X̄ = 152,36, high density lipoprotein X̄ = 39,36 and low density lipoprotein X̄ = 145,01. Result of bivariate analysis with chi square test showed significant relationship of chronic kidney disease stage 4 and 5 with incidence of dyslipidemia (p = 0,002).

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