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

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.

scholarly journals Arteriovenous Shunt (AV Shunt) Sebagai Akses Hemodialisis Pada Pasien Chronic Kidney Disease (CKD)

2020 ◽  
Vol 8 (2) ◽  
pp. 111-116
Author(s):  
Abed Nego Okthara Sebayang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arteriovenous Shunt ◽  
Av Shunt

Latar Belakang : Arteriovenous Shunt (AV Shunt) merupakan tindakan operasi menyambungkan (anastomosis) arteri dan vena pada lengan atau bagian tubuh lain dengan tujuan menjadikan sambungan tersebut sebagai akses hemodialisis. AV shunt adalah gold standart  menciptakan akses vascular untuk hemodialisis pada pasien penyakit ginjal kronik. AV shunt diciptakan untuk meningkatkan efektivitas dari dialysis dan mengurangi risiko dan komplikasi daripada akses vascular lain. Pembahasan : Berdasarkan letaknya, pembuatan AV shunt memiliki prioritas yakni pada lengan bagian distal pada lengan yang tidak dominan. Jika tidak memungkinkan, AV shunt dapat dilakukan pada proksimal lengan tidak dominan dan terakhir pada bagian proksimal lengan yang dominan. Lokasi pergelangan tangan menjadi prioritas utama dalam pembuatan AV shunt karena memiliki keuntungan yang banyak. Arteri dan vena yang umumnya digunakan adalah arteri radialis dan vena cephalica dan arteri brachialis dengan vena cephalica. Kesimpulan : AV shunt adalah gold standart  menciptakan akses vascular untuk hemodialisis pada pasien penyakit ginjal kronik.  . Diharapkan melalui tindakan AV shunt angka harapan hidup pasien gagal ginjal kronik dapat meningkat dan harus didukung oleh disiplin ilmu lainnya seperti interna, psikolog dan keluarga pasien tersebut

Role of Vitamin D in Vascular Complications and Vascular Access Outcome in Patients with Chronic Kidney Disease

2016 ◽  
Vol 23 (17) ◽  
pp. 1698-1707 ◽  
Author(s):  
Domenico Santoro ◽  
Vincenzo Pellicanò ◽  
Valeria Cernaro ◽  
Viviana Lacava ◽  
Antonio Lacquaniti ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vascular Access ◽  
Vascular Complications

Hematologic Abnormalities in Chronic Kidney Disease

2018 ◽  
Author(s):  
Michael Auerbach ◽  
John Anderson ◽  
Khalid Al Talib
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Oral Anticoagulants ◽  
Infusion Reaction ◽  
Nonvalvular Atrial Fibrillation ◽  
Novel Oral Anticoagulant ◽  
Before And After ◽  
Iv Iron ◽  
A Minor

The focus of this review is on information practical to the practicing nephrologist and internists managing patients with chronic kidney disease (CKD), with an emphasis on the quantitative aspects of risk, diagnosis, treatment, and prognosis. Consequently, anemia associated with non–dialysis-associated CKD is emphasized, with special attention to the role of erythropoiesis-stimulating agents and intravenous (IV) iron in treating the anemia of CKD, as well as sections on uremic bleeding and anticoagulation in CKD patients. Figures show a patient before and after a minor infusion reaction, an algorithm outlining grading and management of acute hypersensitivity reactions to IV iron infusions, and an algorithm for the management of uremic platelet dysfunction. Tables list Food and Drug Administration-recommended dose adjustments for novel oral anticoagulant (NOACs) in CKD patients, evidence for preprocedural withholding of NOACs, and management guidelines for anticoagulation in nonvalvular atrial fibrillation and venous thromboembolism. This review contains 2 highly rendered figures, 3 tables, and 101 references. Key words: Chronic kidney disease; CKD; Anemia of chronic kidney disease; Anemia of CKD; Uremic bleeding; Anticoagulation in CKD; Novel oral anticoagulants in CKD; NOAC CKD

P1366THE ROLE OF A NEPHROLOGIST IN THE CREATION OF VASCULAR ACCESS FOR HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gennadii Fomenko
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Access ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Venous Catheter ◽  
Vascular Surgeon ◽  
Dialysis Unit ◽  
The Creation ◽  
Set Up

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.

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

2007 ◽  
Vol 71 (6) ◽  
pp. 555-561 ◽  
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

scholarly journals “PICC”ing Patients with Chronic Kidney Disease

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.

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

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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