scholarly journals Vénafalhoz szívósan szervülő centrális vénás hemodialíziskatéter eltávolítása endovascularis technikával

2019 ◽  
Vol 160 (11) ◽  
pp. 435-437 ◽  
Author(s):  
Viktória Juhász ◽  
Edit Dósa ◽  
Zoltán Oláh ◽  
József Szabó ◽  
Zoltán Szeberin

Abstract: The number of patients with end-stage kidney disease requiring hemodialysis has been growing. The use of permanent central venous dialysis catheters has been increasing. Catheters in the central veins may adhere strongly to the vessel wall, so their removal may lead to difficulties. A recently published endovascular method (so-called Hong technique) turns the catheter removal to an easy and fast outpatient method and avoids sternotomy. We successfully removed a catheter inserted into the left subclavian vein 6 years ago which was impossible to extract by the usual techniques. Based on our experience, we recommend the routine use of the Hong technique. Orv Hetil. 2019, 160(11): 435–437.

Author(s):  
Patrick M. McGah ◽  
Michael Barbour ◽  
Alberto Aliseda ◽  
Kenneth W. Gow

Central venous catheters (CVCs) are used as a way to provide adequate access of blood flow for hemodialysis, a common treatment for end-stage kidney disease. During hemodialysis, the catheter must circulate up to 300 mL/min [1] of blood flow to the extracorporeal artificial kidney. Catheters contain two lumens: the inflow lumen provides flow to the artificial kidney, and the outflow lumen returns it to the patient’s circulation. Although catheters are used in the treatment of patients of all ages, this study is motivated by the use of central venous catheters for pediatric applications; the catheter types and calibers available for children are much more limited than for adults, thereby placing children in a further disadvantage and potentially subjecting them to increased risk of complications.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Fatma AlRahbi ◽  
Issa Alsalmi

Abstract Background and Aims Kidney transplantation is the gold standard for patients with end-stage kidney disease. In view of shortages of available organs, long wait times for possible transplantation, and strict regulation, many patients opt for commercial transplantation. The national diseased program must be a priority with full financial and administrative support. All government agencies including religious affairs must work together to support the program and to provide the citizens with a good transplantation service and ameliorate the impact of commercial transplantation. This study elicits the reasons and motivations for patients with end-stage kidney disease to elect for commercial transplant. Method A questionnaire-based evaluation was conducted during the period from July 2015 until late December 2015. It consisted of 28 multiple choice questions and was distributed to all patients who underwent commercial kidney transplantation. Results One hundred and fifty patients were approached to participate and 106 agreed. Of the participants, 60% were male with an average age of 41.5 (SD 14.8) years and ranged from 18 to 83 years. The majority (82%) of our participants were educated ranging from primary to college level. The major reason (71%) for these participants to obtain commercial transplants was stated as the unavailability of a live related donor. Thirteen percent stated that they objected to getting a kidney donated from a family member, and 9% stated that they were worried about taking a kidney from a family member. Finally, 3% of participants stated that they needed prompt transplant and could not wait for a long time for transplant investigations and the workup associated with this program. Conclusion Even considering the ongoing ethical debates, number of patients undergoing commercial transplantation is on the rise. The study showed that the most common underlying cause for seeking commercial transplantation is the unavailability of a national transplant program, particularly transplantation from cadaveric sources.


2020 ◽  
Vol 40 (11) ◽  
pp. 6525-6530
Author(s):  
JANOS DOCS ◽  
DANIEL BANYAI ◽  
TIBOR FLASKO ◽  
ARPAD SZANTO ◽  
GYULA KOVACS

Author(s):  
Eva Pella ◽  
Afroditi Boutou ◽  
Aristi Boulmpou ◽  
Christodoulos E Papadopoulos ◽  
Aikaterini Papagianni ◽  
...  

Abstract Chronic kidney disease (CKD), especially end-stage kidney disease (ESKD), is associated with increased risk for cardiovascular events and all-cause mortality. Exercise intolerance as well as reduced cardiovascular reserve are extremely common in patients with CKD. Cardiopulmonary exercise testing (CPET) is a non-invasive, dynamic technique that provides an integrative evaluation of cardiovascular, pulmonary, neuropsychological and metabolic function during maximal or submaximal exercise, allowing the evaluation of functional reserves of these systems. This assessment is based on the principle that system failure typically occurs when the system is under stress and, thus, CPET is currently considered to be the gold-standard for identifying exercise limitation and differentiating its causes. It has been widely used in several medical fields for risk stratification, clinical evaluation and other applications but its use in everyday practice for CKD patients is scarce. This article describes the basic principles and methodology of CPET and provides an overview of important studies that utilized CPET in patients with ESKD, in an effort to increase awareness of CPET capabilities among practicing nephrologists.


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