scholarly journals Vascular access for hemodialysis: creation, functioning, and complications (Data of the Hospital of Kaunas University of Medicine)

Medicina ◽  
2010 ◽  
Vol 46 (8) ◽  
pp. 550 ◽  
Author(s):  
Sondra Kybartienė ◽  
Inga Skarupskienė ◽  
Edita Žiginskienė ◽  
Vytautas Kuzminskis
Keyword(s):  
Renal Failure ◽  
Vascular Access ◽  
Ischemic Brain ◽  
End Stage Renal Failure ◽  
Arteriovenous Fistulas ◽  
The Mean ◽  
Group 2 ◽  
End Stage ◽  
Complications Rate ◽  
Mean Time

Background. There are no data about arteriovenous fistulas (AVF) formation, survival, and complications rate in patients with end-stage renal failure in Lithuania. Material and methods. We analyzed the data of patients (N=272) with end-stage renal failure, dialyzed at the Hospital of Kaunas University of Medicine from January 1, 2000, until March 30, 2010, and identified 368 cases of AVF creation. The patients were divided into two groups: group 1 included the patients with an AVF that functioned for <15 months (n=138) and group 2 included patients with an AVF that functioned for ≥15 months (n=171). Results and conclusions. Less than half (47%) of the patients started planned hemodialysis and 51% of the patients started hemodialysis urgently. The mean time of AVF functioning was 15.43±8.67 months. Age, gender, the kidney disease, and time of AVF maturation had no influence on AVF functioning time. AVFs of the patients who started planned hemodialysis functioned longer as compared to AVFs of the patients who started hemodialysis urgently (P<0.05). Hospitalization time of the patients who started hemodialysis urgently was longer as compared that of the patients who had a matured AVF (37.63±20.55 days vs. 16.54±9.43 days). The first vascular access had better survival than repeated access. AVF survival in patients with ischemic brain vascular disease was worse than in patients without this comorbidity.

Ranger™ paclitaxel-coated balloon versus conventional balloon angioplasty for treatment of failing arteriovenous fistulas and grafts in haemodialysis patients: A retrospective cohort study

2021 ◽  
pp. 112972982110670
Author(s):  
Shereen XY Soon ◽  
Ru Yu Tan ◽  
Suh Chien Pang ◽  
Charyl JQ Yap ◽  
Ankur Patel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Cohort Study ◽  
Balloon Angioplasty ◽  
Antiplatelet Agent ◽  
Target Lesion ◽  
End Stage Renal Failure ◽  
Arteriovenous Fistulas ◽  
Conventional Balloon Angioplasty ◽  
End Stage ◽  
Mean Time

Background: Aim was to compare the safety and patency efficacy outcomes between Ranger™ paclitaxel-coated balloon (PCB)- versus conventional balloon angioplasty (POBA) in the treatment of haemodialysis access-related conduit stenosis. Methods: Retrospective single-centre, multi-investigator, consecutive, double-arm comparative cohort study. About 130 end-stage renal failure Asian patients with dysfunctional arteriovenous fistula (AVF) or arteriovenous graft underwent PCB or POBA fistuloplasty between November 2018 and June 2020. All stenotic lesions were prepared with high pressure non-compliant balloon angioplasty prior to PCB angioplasty. All patients received at least one antiplatelet agent for 3 months duration post procedure. Results: Mean age was 66.0 ± 10 years and 79/130 (61%) were males. PCB arm ( n = 65) versus POBA arm ( n = 65). Majority were AVFs circuits (122/130, 94%). Main indication for intervention was dropping access flow (98/130, 76%). About 172 lesions were treated (56% POBA, 44% PCB), and the juxta-anastomosis (JAS) was the main target lesion (87/172, 51%). There were no significant differences in safety outcomes (30-day adverse events, access thrombosis, abandoned AVF and death) between treatment groups. Mean time to target lesion reintervention (TLR) was longer in PCB-treated lesions (7.1 ± 2.7 vs 5.8 ± 3.2 months, p = 0.03), especially amongst recurrent lesions (7.3 ± 2.4 vs 5.7 ± 3.2, p = 0.02). Mean time to circuit reintervention was also longer in PCB-treated circuits (6.9 ± 2.8 vs 5.8 ± 3.7months, p = 0.04). There were 16 deaths (12%), all attributed to patient’s underlying comorbidities. Conclusions: Fistuloplasty with Ranger™ PCB for failing arteriovenous circuits in end-stage renal failure patients, is a safe and efficacious modality compared to POBA in terms of longer freedom from TLR.

Oral and Maxillofacial Manifestations of Mineral and Bone Disorders Associated with Chronic Renal Failure

2017 ◽  
Vol 68 (6) ◽  
pp. 1325-1328
Author(s):  
Andrada Raluca Doscas ◽  
Mihail Balan ◽  
Mihai Liviu Ciofu ◽  
Doriana Agop Forna ◽  
Marius Cristian Martu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Health Concern ◽  
Oral Manifestations ◽  
End Stage Renal Failure ◽  
Brown Tumors ◽  
The Mean ◽  
End Stage

Chronic kidney disease (CKD) is a multifactorial syndrome and a global health concern. As renal function declines, there is a progressive deterioration of mineral homeostasis. Starting from stage 3 of CKD oral manifestations of mineral disorders can occasionally appear and become more frequent and evident in stage 5. We retrospectively analysed 43 patients diagnosed with end stage renal failure undergoing dialysis, hospitalized in our clinic for different oral and maxillofacial pathologies. The mean dialysis period was 5.43 years. Radiographic alterations afecting the jaws were found in all patients. The most common feature was partial or total loss of lamina dura, followed by alterations of the bony trabeculae. 9 patients presented brown tumors which are considered the final stage of secondary hyperparathyroidism associated with renal failure.

scholarly journals Performance of Venous Port Catheter Insertion by a General Surgeon: A Prospective Study

2015 ◽  
Vol 100 (5) ◽  
pp. 827-835 ◽  
Author(s):  
Mehmet Aziret ◽  
Oktay İrkörücü ◽  
Cihan Gökler ◽  
Enver Reyhan ◽  
Süleyman Çetinkünar ◽  
...  
Keyword(s):  
Vascular Access ◽  
Catheter Insertion ◽  
Port Catheter ◽  
Insertion Procedure ◽  
Venous Port ◽  
Stay Time ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

As part of the vascular access procedures, venous ports, commonly referred to as catheters, are placed under the skin to enable safe and easy vascular access for administration of repeated drug treatments. 122 patients who had received a venous port catheter insertion procedure in the general surgery department between January 1012 and January 2014 were involved in this study. Patients were divided into two groups: those who had undergone a fluoroscopy (group 1) and those who had not undergone a fluoroscopy (group 2). Complications that emerged during and after the port catheter insertion procedure and successful insertion rates were recorded in the database. Data of these patients were presented in a prospective manner. There were 92 to 30 patients in groups 1 and 2, respectively. In group 1, the mean age was approximately 56.8, total catheter stay time was 20,631 days, and mean time of port use was 224.2 days. In group 2, the mean age was approximately 61.2, total catheter stay time was 13,575 days, and mean time of port use was 452.5 days. Successful insertion rate was 100% and 90% in groups 1 and 2, respectively (P &lt; 0.05). The proper insertion of the port catheter accompanied by monitoring methods can decrease procedure-related complications. Statistical comparisons between the two groups in terms of malposition and successful insertion rates also support this view (P &lt; 0.05). The findings support the view that in cancer patients, a venous port catheter insertion accompanied by a fluoroscopy can be safely performed by general surgeons.

Biological Grafts for Vascular Access in Patients with End-Stage Renal Failure

1991 ◽  
Vol 25 (5) ◽  
pp. 353-356 ◽  
Author(s):  
M.O. Bitker ◽  
B. Barrou ◽  
C. Mouquet ◽  
Cl. Jacobs ◽  
Ch. Chatelain
Keyword(s):  
Renal Failure ◽  
Vascular Access ◽  
End Stage Renal Failure ◽  
End Stage

scholarly journals A Report of Two Cases of Hazards Associated with High Flow Arteriovenous Fistula in ESRD Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Vipuj Shah ◽  
Rakesh Navuluri ◽  
Yolanda Becker ◽  
Mary Hammes
Keyword(s):  
Renal Failure ◽  
Arteriovenous Fistula ◽  
Cardiac Failure ◽  
High Flow ◽  
End Stage Renal Failure ◽  
Arteriovenous Fistulas ◽  
End Stage ◽  
Prospective Monitoring ◽  
Esrd Patients ◽  
Time Point

High flow arteriovenous fistulas are a common clinical entity affecting patients with end-stage renal failure receiving hemodialysis. Given the difficulty in predicting who will develop a high flow arteriovenous fistula the exact prevalence is unclear. We present two cases of patients with high flow arteriovenous fistula that developed clinical cardiac failure at a time point after the fistula was placed with findings of significant cephalic arch stenosis. Both patients required treatment of cephalic arch stenosis with balloon angioplasty with subsequent surgical aneurism resection. Accurate and timely diagnosis of high flow arteriovenous hemodynamics by prospective monitoring of volumetric flow and cardiac function is required to halt this process prior to cardiac compromise.

BASAL AND TRH-STIMULATED THYROID AND PITUITARY HORMONES IN VARIOUS DEGREES OF RENAL INSUFFICIENCY

1979 ◽  
Vol 90 (1) ◽  
pp. 23-32 ◽  
Author(s):  
M. Weissel ◽  
H. K. Stummvoll ◽  
H. Kolbe ◽  
R. Höfer
Keyword(s):  
Renal Failure ◽  
Renal Insufficiency ◽  
Pituitary Hormones ◽  
Mean Value ◽  
Advanced Stage ◽  
Thyrotrophin Releasing Hormone ◽  
End Stage Renal Failure ◽  
Failure Group ◽  
Group 2 ◽  
End Stage

ABSTRACT Abnormalities of thyroid and pituitary function are well recognized in patients with end-stage renal failure. We have investigated the influence of varying degrees of renal insufficiency on serum thyroid (total thyroxine, TT4; total 3,5,3′-triiodothyronine, TT3, and 3′,5′,3′-triiodothyronine, reverse T3) and pituitary (thyrotrophin, TSH; growth hormone, GH; prolactin, PRL) hormone levels before and after 200 μg thyrotrophin releasing hormone (TRH) iv administration. Patients with mild renal insufficiency (= group 1, plasma creatinine (Cr) > 1.3 mg% but < 3.0 mg%) had normal basal and TRH-stimulated hormone concentrations. In patients at a more advanced stage of the disease (= group 2; Cr > 3.0 mg % but < 7.0 mg %) basal hormone concentrations were also normal. In contrast to the normal group, where no GH reaction to TRH could be detected, GH serum concentrations increased in these patients after TRH. The TT3 and PRL response to TRH remained normal. The TSH reaction to TRH was blunted in four, normal in two and exaggerated in one patient. Patients with end-stage renal failure (= group 3; Cr > 7.0 mg%) had significantly decreased basal TT3 concentrations but a normal TT3 response to TRH. Basal TT4, TT3 and TSH concentrations were normal. The TSH reaction was blunted in four and normal in three patients. The mean basal GH was elevated, albeit not significantly different from the control mean value. The GH increase after TRH was even more pronounced than in group 2. Basal PRL concentrations were significantly increased, but maximal differences between basal and TRH-stimulated concentrations were not significantly different from control. Our data suggest that changes in the pituitary and hypothalamic control of GH are an early consequence of renal insufficiency. Alterations in thyroid function occur simultaneously on the pituitary – hypothalamic and peripheral level at a more advanced stage of the disease. PRL basal levels increase with decreasing renal function. In contrast to other studies we could not observe any significant influence of uraemia on the TRH-stimulated PRL reserve of the pituitary.

The percutaneous endovascular fistula for haemodialysis

2019 ◽  
Vol 4 (5) ◽  
pp. 262-264
Author(s):  
Karen Tullett
Keyword(s):  
Renal Failure ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Clinical Nurse ◽  
End Stage Renal Failure ◽  
Arteriovenous Fistulas ◽  
End Stage

Karen Tullett, a haemodialysis access clinical nurse specialist, describes the advantages of percutaneously created arteriovenous fistulas for end stage renal failure patients

Buttonhole Cannulation on a Femoro-Femoral Fistula: A Successful Approach in a Patient with Difficult Vascular Access

2020 ◽  
Vol 25 (3) ◽  
pp. 56-59
Author(s):  
Eason Chang ◽  
Chun Leong Low ◽  
Jo Anne Lim ◽  
Asri Kassim ◽  
Swe Swe Latt
Keyword(s):  
Renal Failure ◽  
Lower Extremity ◽  
Upper Limb ◽  
Vascular Access ◽  
Dialysis Access ◽  
Renal Failure Patient ◽  
End Stage Renal Failure ◽  
Cannulation Technique ◽  
Successful Approach ◽  
End Stage

Highlights Abstract Vascular access is an essential component for a successful hemodialysis program. Cannulation technique is an important factor for dialysis access survival. For patients with exhausted upper limb vascular access, lower extremity permanent dialysis vascular access (LE-PDVA) is one of the alternatives. The buttonhole cannulation (BHC) technique for LE-PDVA has never been reported in literature. Here we report on a 57-year-old end-stage renal failure patient who had suffered multiple complications related to dialysis access and ended up with exhausted upper limb vascular access. The BHC technique was successfully used on his LE-PDVA for hemodialysis.

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