"Interventional Radiologist: Role in Managing Vascular  Access Problems in Patients with Chronic Kidney  Disease (CKD)"

Abstract Background and Aims The creation of vascular access: has it anything to do with a nephrologist ? At first glance, the concept of vascular access is the responsibility of surgical specialists. However, a nephrologist has started executing some of the common intensive treatment methods, using the equipment and techniques, specific to the field of dialysis. In this case, a nephrology specialist sets up different kinds of vascular access, namely the AV (arteriovenous) fistula, the AV graft, and the venous catheter; he/she is, therefore, responsible for its assessment and congruent correction. Method the usage of statistical data, gathered by the medical specialists of the dialysis unit of the Regional Chernihiv Hospital; the analysis of the possible nephrologist’s contribution to the creation of vascular access in patients with kidney diseases. Results During 2017-2019, 332 catheterizations were performed, during each of them vascular access was established: Conclusion 1. A nephrologist, in collaboration with a vascular surgeon, is particularly interested in the creation of vascular access in a patient with chronic kidney disease at the pre-dialysis stage; 2. In most cases, a nephrologist can set up temporary or permanent vascular access in patients with chronic kidney disease or acute kidney injury, which improves the quality of hemodialysis by making him an active participant of the treatment process.

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Association of diabetes, education level, and care dependency with use of temporary vascular access in patients with chronic kidney disease

Seminars in Dialysis ◽

10.1111/sdi.12930 ◽

2020 ◽

Author(s):

Hung‐Chih Chen ◽

Meng‐Jie Lai ◽

Wan‐Chen Wu ◽

Chi‐Yu Lee ◽

Hsuan‐Jen Lin ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Access ◽

Diabetes Education ◽

Education Level ◽

Care Dependency

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When to refer patients with chronic kidney disease for vascular access surgery: Should age be a consideration?

Kidney International ◽

10.1038/sj.ki.5002078 ◽

2007 ◽

Vol 71 (6) ◽

pp. 555-561 ◽

Cited By ~ 91

Author(s):

A.M. O'Hare ◽

D. Bertenthal ◽

L.C. Walter ◽

A.X. Garg ◽

K. Covinsky ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Access ◽

Vascular Access Surgery ◽

Access Surgery

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“PICC”ing Patients with Chronic Kidney Disease

Pakistan Journal of Kidney Diseases ◽

10.53778/pjkd4265 ◽

2021 ◽

Vol 4 (2) ◽

Author(s):

Sonia Yaqub ◽

Muhammad Raheel ◽

Abdul Razzaque ◽

Zarghoona Naeem

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Access ◽

Estimated Glomerular Filtration Rate ◽

Tertiary Care ◽

Care Hospital ◽

Line Placement ◽

The Future ◽

Local Trauma ◽

Central Catheters

Patients with Chronic Kidney Disease (CKD) eventually progress to kidney failure and require dialysis. These patients often present withcomplicated medical conditions requiring intravenous medical therapies; however, at the same time it is of paramount importance to maintain integrity of veins to provide a future hemodialysis (HD) vascular access. Peripherally inserted central catheters (PICC) are used for patients requiring prolonged intravenous medications. PICC lines may cause local trauma and influence the future vascular access creation. The aim of this study was to determine the frequency and indications of PICC lines use in hospitalized patients at a tertiary care hospital. Patients and Methods: All patients were retrospectively reviewed over 2 months for PICC line placement, indications and their estimated glomerular filtration rate. Results: Total of 147 PICC lines were placed and 20% of such patients had an eGFR <60 ml/min with possible need of vascular access in future. Conclusion: Placement of PICC lines in CKD patients is common and should be discouraged due to the possible need in the future for vascular access.

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P0836ROLE OF THE NEPHROLOGIST AS A CONSULTANT FOR VASCULAR SURGERY SERVICE IN A UNIVERSITY HOSPITAL

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0836 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Orlando Siverio Morales ◽

Edduin Martin ◽

Virginia Dominguez ◽

Carlos Marin ◽

Ana Aragao ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Surgery ◽

Vascular Access ◽

University Hospital ◽

Hospitalised Patients ◽

Number Of Patients ◽

Clinical Conditions

Abstract Background and Aims The clinical profile and complexity of hospitalised patients from Vascular Surgery are similar to those from Nephrology. Also, the majority of patients with peripheral vascular disease has some degree of chronic kidney disease. Therefore, the collaboration of nephrologist as consultants could have a significant impact on the adequate attention of these patients. Our aim was to analyze the epidemiological and clinical characteristics of the vascular surgery patients admitted in a public university hospital of 1000 beds that were attended by a nephrologist during their hospitalization. Method Observational study of a retrospective cohort of 138 patients in a 1 year period (January 1st to December 31st 2018). The following data were considered: nature of the consultation (“Urgent” LESS THAN 24 H TO BE ATTENDER OR “Standar”), reason for consultation/nephrological diagnosis, cause of admission, follow-up period, age, sex, presence of : Diabetes Mellitus (DM), Hypertension (HT) and/or Chronic Kidney Disease (CKD) presence. Results 138 patients, Mean age was 67,8 y (range 35-92 y). 76,81% were men and 23,19% were women. Most frequent cause for consultations were: 1. Patients on Hemodialysis treatment (66 = 47,83%); 2. Exhacerbations of CKD (29 = 21,01%); 3. Acute Kidney Failure (18 = 13,04%); 4. Kidney transplantation (11 = 7,97%); 5. Ionic alterations (7 = 5,07%); 6. Advanced CKD (6=4,35%). Cause of admission: 1. Chronic lower limb ischemia (68=49,27%); 2. Problems related to arteriovenous fistula (Creation of vascular access: 10=7,25% and complications of vascular access: 16=11,59%); 3. Aneurysmatic complications (14=10,14%); 4. Diabetic foot (11=7,97%); 5. Infections (7=5,07%); 6. Deep venous thrombosis (6=4,35%). About 75.35% had DM, 91.30% were hypertensive and 62.32% had both clinical conditions. The average follow-up time was 72 days (range 1-223 days) and 92,03 % need to be follow-up more than 24 hours. About 49,27% of the consultation were urgent. Conclusion The number of patients admitted to vascular surgery department requiring nephrology attention are high and represents an important percentage of the clinical activities and resources demanding to the nephrology service. Exhacerbations of CKD, Diabetes Mellitus and Hypertension are constant clinical conditions in patients admitted to vascular surgery requiring nephrology assessment. Based on these data is important to improve the coordination between both departments and to stablish a specific training program for nephrologist and vascular surgeons in order to optimize the management of this patients.

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Different Clinical Practice in Hemodialysis in Mexico and Colombia

Mexican Journal of Medical Research ◽

10.29057/mjmr.v7i14.3831 ◽

2019 ◽

Vol 7 (14) ◽

pp. 1-5

Author(s):

Nelly Patricia Calderón- Rodríguez

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Access ◽

Health Personnel ◽

Public Health Problem ◽

Therapeutic Modality ◽

Renal Unit ◽

Clinical Practices ◽

Acid Base Balance ◽

Waste Products

Chronic kidney disease is the structural or functional damage of the kidneys for more than three months and is considered a public health problem, since one out of every ten adults suffer from; the hemodialysis is a therapeutic modality that replaces kidney function (excretion of waste products, regulation of water balance and regulation of the acid-base balance) improving the quality and years of life in patients with chronic kidney disease. However, clinical practices used (dialyzers, duration of hemodialysis sessions, vascular access and health personnel) vary in each country, which has an impact on the quality of life and patient mortality. Objective: To describe the differences in the reuse of dialyzers, duration of hemodialysis sessions, goals for the type of vascular access used and the health personnel who are in each renal unit, from the rules, between Mexico and Colombia. Conclusions: The differences that exist in clinical practices of hemodialysis between Mexico and Colombia are given from the health standards, however, it is necessary reinforce aspects in the both countries to provide better care for patients with chronic kidney disease.

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Arteriovenous shunt as the best hemodialysis access in Chronic Kidney Disease (CKD) patients: a literature review

Journal of Indonesia Vascular Access ◽

10.51559/jinava.v1i1.6 ◽

2021 ◽

Vol 1 (1) ◽

pp. 1-3

Author(s):

Abed Nego Okthara Sebayang ◽

Niko Azhari Hidayat

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Access ◽

Body Part ◽

Arteriovenous Shunt ◽

Hemodialysis Access ◽

Literature Study ◽

A Minor ◽

Av Shunt ◽

Arteries And Veins

Arteriovenous Shunt (AV Shunt) is a minor surgical operation that connects (creating anastomoses) the arteries and veins in the arm or other body part for the purpose of making connection access for hemodialysis. AV shunt is the primary choice in establishing vascular access for hemodialysis in patients with Chronic Kidney Disease (CKD). Therefore, this study aims to review the arteriovenous shunt as a hemodialysis access option in CKD patients. The literature study was conducted by searching various written sources, whether in the form of books, archives, articles and journals, or documents relevant to the problem being studied. The mortality rate after AV shunt is 0%, even though it still has postoperative complications. Based on the location of the operation, making the AV shunt is prioritized on the distal part that is not dominant to minimize the damage to the AV shunt. The location of the wrist, namely the brachiocephalic, is a top priority in making an AV shunt because it has many advantages. AV shunt is the primary choice of vascular access for hemodialysis in patients with chronic kidney disease. It is hoped that through the AV shunt, the life expectancy of patients with CKD can be increased, and patients with CKD must receive support from other disciplines such as interns, psychologists, and the patient's family.

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Arterio-Venous (AV) Fistula: Surgical outcome in College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v8i4.8693 ◽

2013 ◽

Vol 8 (4) ◽

pp. 1-6

Author(s):

S Shah ◽

N Maharjan ◽

D Chapagain ◽

KG Shrestha ◽

DJ Reddy

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Arteriovenous Fistula ◽

Vascular Access ◽

Fistula Formation ◽

Limiting Factor ◽

Safe Procedure ◽

Medical Sciences ◽

Av Fistula ◽

Made In

Aims Arteriovenous fistula is considered as reliable form of vascular access for hemodialysis in Chronic Kidney Disease (CKD) patients. We aim to evaluate prospectively, the outcome and primary failure rate of Arteriovenous fistula in 30 Chronic kidney Disease patients with Glomerular Filtration Rate (GFR) <30ml/min. Materials and methods This prospective study was conducted at the department of cardiothoracic and vascular surgery (CTVS), College of Medical Sciences, Bharatpur from May 2011 to May 2012. Thirty patients ranging from age 25 to 76 years with stage IV and V CKD, i.e. GFR below 30ml/min, were included in this study. Detailed physical examination including arterial pulses i.e. axillary, brachial, radial and ulnar and blood pressure in both upper limbs was recorded. Allens test was performed on every patient and left upper limb was used for AV fistula formation. Brachiocephalic fistula was made in 19 (63.33%), while radiocephalic fistula was made in 11 (36.67%) patients. Patients were evaluated post operatively, on outdoor basis, weekly for 6weeks. All patients were evaluated for the presence or absence of complications i.e. infection, hematoma, thrombosis, aneurysms and steal syndrome. Results The complication was primary failure in two patients. One male patient got secondary infection and one female patient got post operative hematoma leading to 6.66% primary failure of fistula. No other complications were noted. Conclusion Arteriovenous fistula is the gold standard for vascular access for hemodialysis in patients with deteriorating renal function and end-stage renal disease. It is designed to improve the effectiveness of dialysis with fewer risks and complications than other vascular accesses. This study gives the higher success rate of 93.33% and concludes that age should not be a limiting factor when determining candidacy for arteriovenous fistula creation and is the safe procedure. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 1-6 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8693

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