scholarly journals A Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease

2021 ◽  
Vol 14 (1) ◽  
pp. 44-49
Author(s):  
Md Nazmus Sabah ◽  
SM Parvez Ahmed ◽  
Md Saif Ullah Khan ◽  
Rakibul Hasan ◽  
Md Fidah Hossain ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Color Doppler ◽  
Maturation Time ◽  
Doppler Study ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD). Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation. Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%). Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site. Cardiovasc j 2021; 14(1): 44-49

scholarly journals Effect of local papaverine on arteriovenous fistula maturation in patients with end-stage renal disease

2019 ◽  
Vol 41 (2) ◽  
pp. 185-192 ◽  
Author(s):  
Reza Manani ◽  
Gholamreza Kazemzadeh ◽  
Ali Saberi ◽  
Fatemeh Sadeghipour ◽  
Asghar Rahmani
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Case Group ◽  
Maturation Time ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Control ◽  
Fistula Maturation

Abstract Background: Arteriovenous fistula (AVF) maturation is one of the main concerns in patients with end-stage renal disease (ESRD) and finding a strategy for increasing success rate and accelerating fistula maturation is valuable. The aim of this study was to evaluate the effects of papaverine injection on AVF maturation and success rate. Method: This study was a randomized clinical trial that involved 110 patients with ESRD that were referred for AVF construction. Patients were allocated in papaverine group and control group with block randomization according to age and sex. In the case group, papaverine (0.1 or 0.2 cc) was injected locally within the subadventitia of artery and vein after proximal and distal control during AVF construction and in the control group, AVF construction was done routinely without papaverine injection. Results: Maturation time in case and control groups was 37.94 ± 11.49 and 44.23 ± 9.57 days, respectively (p=0.004). Hematoma was not seen in the case group but occurred in one patient in the control group. One patient of the case group developed venous hypertension. Four functional fistulas, 1 (1.8%) in the case group and 3 (5.5%) in the control group, failed to mature (p=0.618). Maturation rate did not differ between the two groups statistically (p=0.101). Conclusion: Local papaverine injection increased vessel diameter and blood flow, increasing shearing stress in both arterial and venous segment of recently created AVF. In this way, papaverine probably can decrease AVF maturation time without an increase in complications.

scholarly journals Cytokine Signature in End-Stage Renal Disease Patients on Hemodialysis

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Danyelle Romana Alves Rios ◽  
Melina Barros Pinheiro ◽  
Wander Valadares de Oliveira Junior ◽  
Karina Braga Gomes ◽  
Andréa Teixeira Carvalho ◽  
...  
Keyword(s):  
Renal Disease ◽  
Vascular Access ◽  
The Body ◽  
T Helper ◽  
T Helper 1 ◽  
Group I ◽  
Group Ii ◽  
Inflammatory Profile ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis is a modality of blood filtration in which accumulated toxins and water are removed from the body. This treatment is indicated for patients at the end stage of renal disease. Vascular access complications are responsible for 20–25% of all hospitalizations in dialyzed patients. The occurrence of thrombosis in the vascular access is a serious problem that may severely compromise or even make the hemodialysis impossible, which is vital for the patient. The aim of this study was to investigate inflammatory profile in patients undergoing hemodialysis as well as the association between these alterations and vascular access thrombosis. A total of 195 patients undergoing hemodialysis have been evaluated; of which, 149 patients had not experienced vascular access thrombosis (group I) and 46 patients had previously presented this complication (group II). Plasma levels of cytokines including interleukin (IL-) 2, IL-4, IL-5, IL-10, TNF-α, and IFN-γwere measured by cytometric bead array. Our results showed that patients with previous thrombotic events (group II) had higher levels of the IL-2, IL-4, IL-5, and IFN-γwhen compared to those in group I. Furthermore, a different cytokine signature was detected in dialyzed patients according to previous occurrences or not of thrombotic events, suggesting that elevated levels of T-helper 1 and T-helper 2 cytokines might, at least in part, contribute to this complication.

RELATIONSHIP BETWEEN NUTRITIONAL CONDITIONS AND RATE OF PROTEIN DEGRADATION LEVELS IN PATIENTS CHRONIC KIDNEY DISEASE HEMODIALYSIS

2017 ◽  
pp. 132-137
Author(s):  
Thanh Hung Vo ◽  
Bui Bao Hoang ◽  
Minh Chu Cao
Keyword(s):  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
Renal Dialysis ◽  
Severe Malnutrition ◽  
Multivariate Logistic Regression ◽  
Dialysis Patients ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Objectives: To investigate malnutrition and the correlation between nutrient status and rate of protid degeneration (nPCR) in end stage renal disease patients undergoing dialysis. Object and method: A crosssectional study of 207 hemodialysis patients in the Department of Internal Medicine - Urology - Hemodialysis, Can Tho General Hospital. Results: The malnutrition rate according to SGA_3 for cyclic renal dialysis patients was severe malnutrition (27.8%), with statistically significant difference (p <0.05), severe body mass index (BMI) was 2.9% in dialysis patients. The difference between men and women was statistically significant (p <0.05) Serum malnutrition, 4.8% in patients with cyclic human nephropathy, was statistically significant (p <0.05) between levels of malnutrition and concentration Serum prevalence, severe malnutrition, accounted for 17.9% in patients with cyclic human renal disease, statistically significant (with p <0.05) among malnutrition groups. The nPCR concentration was positively correlated with serum albumin concentration. In multivariate logistic regression, nPCR concentrations correlated with BMI. Conclusion: Severe malnutrition according to SGA_3 accounts for 27.8%, there is a difference between men and women, severe BMI malnutrition accounts for 2.9%, Serious albumin malnutrition accounts for 4.8 % and severe malnutrition under serum prealbumin accounted for 17.9% between the different methods, the difference was statistically significant when p <0.05. The level of nPCR is positively correlated with serum albumin. In multivariate logistic regression, nPCR concentrations correlated with BMI. Key words: nPCR, BMi, SGA_3, serum albumin, serum albumin, serum leptin, end stage renal disease, renal dialysis, malnutrition

scholarly journals Comparison of Lipid Profile Among the Different Stages of Chronic Kidney Disease in Children

KYAMC Journal ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 137-142
Author(s):  
Muhammad Mozammel Haque ◽  
Mosammat Afroza Jinnat ◽  
Shafi Ahmed ◽  
Ranjit Ranjan Roy ◽  
Mohammad Akteruzzaman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Lipid Profile ◽  
End Stage Renal Disease ◽  
Obstructive Uropathy ◽  
Group I ◽  
Ckd Stage ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic Kidney Disease (CKD) is associated with significantly increased morbidity and mortality. Children with (CKD)/End stage renal disease (ESRD) exhibit various co-morbidities, including dyslipidemia. Hypertriglyceridemia is inversely correlated with renal function. Children with advanced chronic kidney disease or end stage renal disease developed atherosclerosis and cardiovascular disease. Objectives: To measure the lipid profile in kidney disease and comparison of lipid profile among the different stages of CKD. Materials and Methods: A cross sectional analytic study to measure and compare lipid profile in fifty children with different stages of chronic kidney disease during January 2016 to June 2016 by purposive sampling technique and divided into two groups, Children with CKD stage iii and iv included in Group I and CKD stage V and V(D) included in Group II. Results: Out of Fifty children with CKD, 28(56%) were male and 22 (44%) male, 30(60%) were of11-15 year age group and 32(64%) were from rural area and 18(36%) from urban area. The etiology of CKD in two groups glomerulonephritis were 14(28%), obstructive uropathy 15 (30%), hypoplasia/dysplasia 9(18%), polycystic kidney disease 9(18%) and acute kidney injury 3(6%). All the cases were anemic, 26(52%) were hypertensive and 20(40%) had osteodystrophy. Conclusion: Dyslipidemia specially hypertriglyceridemia is common in children with CKD. Hypertriglyceridemia is inversely related to severity of CKD stages. KYAMC Journal Vol. 10, No.-3, October 2019, Page 137-142

scholarly journals Spectrum of vascular abnormalities in color Doppler examination of upper extremities tested for suitability for AV fistula creation in patients of renal failure

2017 ◽  
Vol 4 (1) ◽  
pp. 47
Author(s):  
Seema Grover ◽  
Suprabhat Bolisetti ◽  
Shailesh Sangani ◽  
Sonali Gadhavi ◽  
Neeraja Kulkarni
Keyword(s):  
Renal Disease ◽  
Success Rate ◽  
End Stage Renal Disease ◽  
Upper Extremities ◽  
Upper Limbs ◽  
Av Fistula ◽  
Vascular Abnormalities ◽  
Doppler Study ◽  
Stage Renal Disease ◽  
End Stage

Background: Almost all patients with end stage renal disease require haemodialysis at some stage of their disease and arteriovenous fistula is the most convenient option. The purpose of this study was to analyse the prevalence of vascular abnormalities in the upper limbs of patients posted for creation of haemodialysis access. Knowledge of the variant anatomy of upper limb vessels helps in better planning of surgery, avoiding unnecessary surgery and improving the success rate of haemodialysis access creation.Methods: This study is a retrospective analysis of colour Doppler study of 150 upper extremities of end stage renal disease patients posted for AV fistula creation. The limbs were evaluated for arterial and venous anatomy rendering them fit or unfit for fistula creation.Results: We found abnormal vasculature in more than 60% of the upper limbs. Congenital arterial abnormality was found in 9 % of upper limbs and venous abnormality was found in 65 % of upper limbs. Unnecessary surgery could be avoided in approximately 74 % of patients. 10 % had correctable abnormality.Conclusions: Pre-operative ultrasound and Doppler assessment resulted in more patients being subjected to proximal fistulas and alternate suitable dialysis processes like permcath or peritoneal dialysis. Primary fistula success rate obtained by this pre-operative evaluation was close to 95 %.

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