scholarly journals A three years’ experience of Arteriovenous Fistula (AVF) cases in a tertiary care hospital of East Java, Indonesia: a descriptive observational study

2021 ◽  
Vol 1 (2) ◽  
pp. 24-27
Author(s):  
Rafaela Andira Ledyastatin ◽  
Caesario Tri Prasetyo ◽  
Gold Sunday Palm Tampubolon ◽  
Dhihintia Jiwangga
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Tertiary Care Hospital ◽  
Local Population ◽  
Tertiary Care ◽  
Underlying Disease ◽  
Care Hospital ◽  
Arteriovenous Fistulas ◽  
Stage Renal Disease ◽  
End Stage

Introduction: The incidence of end-stage renal disease (ESRD) globally is 700 million people approximately. Patients with ESRD need vascular access for hemodialysis as renal replacement therapy (RRT). Among hemodialysis access, arteriovenous fistula is considered as the most preferred form of vascular access due to its characteristics. This study aimed to to present a descriptive characteristic of arteriovenous fistula creation cases in a tertiary care hospital with a specific view of demographic parameters, fistulas' sites, type of fistulas. Methods: We conducted a descriptive study of single-center in the Department of Thoracic, Cardiac and Vascular Surgery of Dr. Soetomo Academic General Hospital Surabaya, collected data from January 1st, 2017 to December 31st, 2020. All patients who undergo arteriovenous fistula creation considered as a subject in this study. We retrieved the characteristics of the patients, the type of fistula, the site, surgical technique, and underlying disease from patients’ electronic medical data records. Results: A total of 167 patients requiring long-term hemodialysis in our center. Females were dominantly in our study with 56.9% (95). Most of AVFs were created on the left arm. Radiocephalic type of AVF was the most common arteriovenous fistula type found in 111 subjects (66.5%). The highest postoperative successful rate was found in brachiocephalic type in 78.8%, followed by radiocephalic AVF type with 66.7%. The wrist region was favorable in subjects (43.1%). Conclusions: Arteriovenous fistulas for hemodialysis are needed and in our center. Radiocephalic AVFs are the most common type. Further study to learn the different aspects of arteriovenous fistula cases is needed to fulfill queries in the local population.

Arteriovenous fistulas for hemodialysis: Brief review and current problems

2021 ◽  
pp. 112972982110077
Author(s):  
John J Manov ◽  
Prasoon P Mohan ◽  
Roberto Vazquez-Padron
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
State Of The Art ◽  
Arteriovenous Fistulas ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
End Stage

The number of people worldwide living with end-stage renal disease is increasing. Arteriovenous fistulas are the preferred method of vascular access in patients who will require hemodialysis. As the number of patients with arteriovenous fistulas grows, the role of physicians who intervene who maintain and salvage these fistulas will grow in importance. This review aims to familiarize practitioners with the rationale for arteriovenous fistula creation, the detection of fistula dysfunction, and the state of the art on fistula maintenance and preservation. Current controversies are briefly reviewed.

scholarly journals Study of Arteriovenous Fistula Cases in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (225) ◽  
Author(s):  
Robin Man Karmacharya ◽  
Satish Vaidya ◽  
Amit Kumar Singh ◽  
Sushil Dahal ◽  
Prasesh Dhakal ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Axillary Vein ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Arteriovenous Fistulas ◽  
Common Location

Introduction: Arteriovenous fistulas are a preferred choice for hemodialysis access in chronickidney disease patients. There is increased adoption of arteriovenous fistula creation in Nepal.Our objective is to study various arteriovenous fistulas that have been created in our center. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital includingall cases of arteriovenous fistula creation from January 2018 to December 2019. We obtained theethical clearance from the institutional review committee of Kathmandu University School ofMedical sciences. Convenient sampling method was used. Detailed vascular mapping and colordoppler ultrasonography was done in the bilateral upper limb as preoperative preparation and tochoose a site for arteriovenous fistula creation. Data were entered into the Statistical Package for theSocial Sciences version 20 for analysis. Results: Among 50 patients, the most common location was brachiobasilic 20 (40%) patients followedby brachiocephalic 18 (36%), radiocephalic 11 (22%), and arteriovenous graft between the brachialartery and axillary vein 1 (2%). The mean duration of hospital stay was 1.44 days. Three (6%) patientsrequired re-intervention, all within 24 hours. Two (4%) patients had a failure of arteriovenous fistularequiring the creation of a new arteriovenous fistula. Conclusions: Brachiobasilic was the most common location for arteriovenous fistula creation.Reintervention was not common.

scholarly journals Comparison of Paricalcitol (I.V) and Alfacalcidol (I.V) in Treatment of Secondary Hyperparathyroidism (SHPT) in Hemodialysis Patients

2020 ◽  
Vol 24 (4) ◽  
pp. 378-383
Author(s):  
Mansoor Abbas Qaisar ◽  
Zain Ul Abideen ◽  
Fateh Sher Chattah ◽  
Muhammad Nadeem ◽  
Zahid Hafeez
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Open Label ◽  
Dialysis Unit ◽  
Stage Renal Disease ◽  
End Stage

ABSTRACT   Objective of study: To Compare the efficacy of Alfacalcidol (I.V) and Paricalcitol (I.V) for the treatment of secondary hyperparathyroidism  (SHPT)  in hemodialysis patients. Materials and Methods: An open-label randomized clinical trial  carried out to compare the efficacy of intravenous paricalcitol and alfacalcidol. We recruited 80 patients with end stage renal  disease receiving  maintenance hemodialysis in a tertiary care hospital dialysis unit. The participants were randomly divided into two  groups. A wash out period of one week was decided for each patient in which he/she did not receive any medication for treatment of hypocalcemia, hyperphosphatemia or secondary hyperparathyroidism. Afterwards, patients  received  expanding dosage of alfacalcidol or paricalcitol  for a time of about four months and then after a further wash out period of one week, each group received  opposite treatment (paricalcitol or alfacalcidol) for further  four months (16 weeks). Results: The analyzed data for the same end points revealed no difference between the two groups. No significant statistical difference in terms of  calcium levels in both groups was noted. The study also found no big difference  in the ability of both drugs to treat secondary hyperparathyroidism, while keeping serum phosphate and calcium levels inside the desired range. The study also found no distinction in the frequency of hypercalcemia and  hyperphosphatemia as a side effect of Vitamin D analogue’s treatment.   Conclusion: The study concludes that alfacalcidol and paricalcitol are equally effective in treatment of secondary hyperparathyroidism in dialysis population. Since Paricalcitol is expensive as compared to alfacalcidol, in an economically challenged country like Pakistan, Alfacalcidol can be a better  choice when treating SHPT as we did not  find any gross difference in the ability of two drugs to restrict SHPT.   Keywords:  Alfacalcidol, Paricalcitol, Secondary hyperparathyroidism, Hemodialysis.

scholarly journals A Two Year Observation on Trend of Primary Glomerulonephritis in A Tertiary Care Hospital of Bangladesh

2016 ◽  
Vol 27 (2) ◽  
pp. 68-70
Author(s):  
Tabassum Samad ◽  
Wasim Md Mohosin Ul Haque ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
Sarwar Iqbal
Keyword(s):  
Membranoproliferative Glomerulonephritis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Hospital ◽  
Cross Sectional ◽  
Primary Glomerulonephritis ◽  
Common Causes ◽  
Stage Renal Disease ◽  
End Stage

Aim: Glomerulonephritis remains the most probable underlying cause of end stage renal disease of uncertain aetiology in many developing countries, including Bangladesh. The pattern of glomerular disease varies widely from country to country. In Bangladesh, the incidence and histological pattern of glomerulonephritis is inadequately described. We performed a study, aiming to determine pattern of primary glomerulonephritis in a tertiary care hospital of our country.Material & Methods: It was a cross-sectional hospital based prospective study conducted at BIRDEM general hospital starting from from July 2013 to June 2015. It included all patients with primary glomerulonephritis and who underwent native kidney biopsy.Result: Total 67 biopsy were performed and among them primary glomerulonephritis was 42. Female and male ratio was 1.3:1 and mean age was 42.73±14 (14-75) years. Indications of biopsy were proteinuria (>1gm/day) and unexplained acute kidney injury. The commonest histopathological pattern in primary glomerulonephritis was membranoproliferative glomerulonephritis 33.33% (14/ 42) followed by mesangial proliferative glomerulonephritis 30.95% (13/42). Only three (7%) patient required blood transfusion for post biopsy bleeding. No one required nephrectomy.Conclusion: In conclusion, mesangial proliferative and membranoproliferative glomerulonephritis are the two most common causes of primary glomerulonephritis. Nephrotic range proteinuria was the main indication of biopsy. Post biopsy complication was negligible. Creation of a national renal registry is essential for obtaining more specific epidemiological data.Bangladesh J Medicine Jul 2016; 27(2) : 68-70

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

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