scholarly journals Factors Affecting Arteriovenous Fistula (AVF) Maturation

2021 ◽  
Vol 1 (2) ◽  
pp. 81-87
Author(s):  
Cahya Nabila ◽  
Salwa Khairunnisa ◽  
Holila Sajidah

AVF requires postoperative maturation before cannulation to initiate hemodialysis treatment. AVF maturation usually takes about six weeks and depends on the development of vascular remodeling. However, AVF surgery is not always followed by successful maturation. Recent studies have shown that the rate of maturation failure in patients with chronic kidney disease undergoing AVF-type vascular access establishment is very high, ranging from 20% to 60%. The source search was carried out on the online portal of journal publications as many as 12 sources from Medscape, Google Scholar, National Center for Biotechnology Information (NCBI) with the keywords chronic kidney disease, hemodialysis, AVF, and maturation. Many factors are involved in the functional maturation of AVF, including age, sex, coagulation factors, lipid profile, hypoalbumin, venous diameter, diabetes, hypertension, peripheral vascular disease, smoking, obesity, and dialysis. Failure of AVF maturation results in insufficient blood flow to allow cannulation and initiation of hemodialysis.

2011 ◽  
Vol 33 (3) ◽  
pp. 250-259 ◽  
Author(s):  
Joseph Gawdzik ◽  
Liby Mathew ◽  
Gene Kim ◽  
Tipu S. Puri ◽  
Marion A. Hofmann Bowman

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Demetria Hubbard ◽  
Lisandro D. Colantonio ◽  
Robert S. Rosenson ◽  
Todd M. Brown ◽  
Elizabeth A. Jackson ◽  
...  

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.


2018 ◽  
Vol 4 (2) ◽  
Author(s):  
May Dwi Yuri Santoso

The action of hemodialysis in patients with chronic kidney disease can trigger anxiety due to situational crisis, death threat and not know the final result of hemodialysis action. The purpose of this systematic review is to gain an understanding of the anxiety of patients with chronic kidney disease with hemodialysis action. The results of a review of 15 journals that have been selected suggest that patients with chronic kidney disease with hemodialysis actions mostly experience anxiety. The most widely used instruments are (HADS) Hospital Anxiety And Depression Scale (n = 5). Factors affecting anxiety of chronic kidney disease patients with hemodialysis action are social demographic factors such as sex, age, occupation, duration of hemodialysis and education. Other factors are psychological, social perception, non pharmacological action (progressive muscular), (aroma therapy) and spiritual intelligence. The conclusion that anxiety disorder is very important, and appropriate Instrument will affect patient objective anxiety results. The need for a team collaborative approach to reduce anxiety of patients with chronic kidney disease by hemodialysis. Keywords : Anxiety, Chronic Kidney Disease, Hemodialysis


2011 ◽  
Vol 300 (6) ◽  
pp. F1431-F1436 ◽  
Author(s):  
Keith Ng ◽  
Cara M. Hildreth ◽  
Jacqueline K. Phillips ◽  
Alberto P. Avolio

Increased aortic pulse-wave velocity (PWV) reflects increased arterial stiffness and is a strong predictor of cardiovascular risk in chronic kidney disease (CKD). We examined functional and structural correlations among PWV, aortic calcification, and vascular remodeling in a rodent model of CKD, the Lewis polycystic kidney (LPK) rat. Hemodynamic parameters and beat-to-beat aortic PWV were recorded in urethane-anesthetized animals [12-wk-old hypertensive female LPK rats ( n = 5)] before the onset of end-stage renal disease and their age- and sex-matched normotensive controls (Lewis, n = 6). Animals were euthanized, and the aorta was collected to measure calcium content by atomic absorption spectrophotometry. A separate cohort of animals ( n = 5/group) were anesthetized with pentobarbitone sodium and pressure perfused with formalin, and the aorta was collected for histomorphometry, which allowed calculation of aortic wall thickness, medial cross-sectional area (MCSA), elastic modulus (EM), and wall stress (WS), size and density of smooth muscle nuclei, and relative content of lamellae, interlamellae elastin, and collagen. Mean arterial pressure (MAP) and PWV were significantly greater in the LPK compared with Lewis (72 and 33%, respectively) animals. The LPK group had 6.8-fold greater aortic calcification, 38% greater aortic MCSA, 56% greater EM/WS, 13% greater aortic wall thickness, 21% smaller smooth muscle cell area, and 20% less elastin density with no difference in collagen fiber density. These findings demonstrate vascular remodeling and increased calcification with a functional increase in PWV and therefore aortic stiffness in hypertensive LPK rats.


2021 ◽  
Vol 1 (29) ◽  
pp. 21-27
Author(s):  
S. A. Smakotina ◽  
Yu. A. Bokhanov

Objective. Patients with stage 5 chronic kidney disease.Study objective. Determination of factors affecting cognitive function in patients with CKD-5.Design and methods. The study included young and middle-aged patients (18 to 60 years old) (n = 40), there is a terminal stage of chronic kidney disease (CKD). Exclusion criteria: history of diseases of the central nervous system, brain injury, episodes of cerebrovascular accident with severity, coronary artery disease, chronic heart failure, pregnancy, abuse of alcohol, refusal to participate in the study. In a previous work, patient examination data were obtained on the Status PF hardware complex. Neurodynamic indicators were estimated, including the determination of the time of a simple visual-motor reaction (MTCM) and a complex visual-motor reaction (MPSM), reaction to a moving object (RDO), memory and attention. Using Spearman’s correlation analysis, we evaluated the impact on cognitive functions of a number of factors, presumably related to neurodynamics. The following factors were selected: age, creatinine level, NSE and S100 proteins, hemoglobin level, Beck’s depression points, indicators of personal and situational anxiety.Results. All patients examined on the Status PF software package had mild cognitive impairment in terms of neurodynamics, attention, and memory. The average positive relationship between the level of depression and various indicators of RDO was established: with RDO_average (ρ = 0.405; p = 0.018), with RDO_total delay (ρ = 0.540; p < 0.001), with RDO_average delay (ρ = 0.421; p = 0.007), as well as weak positive – with CEMR average exposure (ρ = 0.358; p = 0.023). An average positive relationship of creatinine level with RDO_O (ρ = 0.438; p = 0.005) is noted. A weak positive relationship between the level of personal anxiety and RDO_total delay (ρ = 0.334; p = 0.035) was revealed. The average negative relationship between hemoglobin level and RDO_total delay (ρ = –0.535; p < 0.001) was revealed. A weak positive relationship between situational anxiety and SEMR is determined by the number of errors (ρ = 0.364; p = 0.021), as well as a weak negative one with the attention volume (ρ = –0.357; p = 0.024). A weak negative relationship of age with visual memory per word was revealed (ρ = –0.362; p = 0.022).Domain of usage. Outpatient and hospital treatment stages of patients with chronic kidney disease case management


2016 ◽  
Vol 45 (1) ◽  
pp. 4-13 ◽  
Author(s):  
Kristin M. McCabe ◽  
Sarah L. Booth ◽  
Xueyan Fu ◽  
Emilie Ward ◽  
Michael A. Adams ◽  
...  

Background: Patients with chronic kidney disease (CKD) have very high levels of uncarboxylated, inactive, extra-hepatic vitamin K-dependent proteins measured in circulation, putting them at risk for complications of vitamin K deficiency. The major form of vitamin K found in the liver is phylloquinone (K1). Menaquinone-4 (MK-4) is the form of vitamin K that is preferentially found in extra-hepatic tissues. Methods: In the present study, we assessed tissue concentrations of K1 and MK-4 and the expression of vitamin K-related genes in a rat model of adenine-induced CKD. Results: It was found that rats with both mild and severe CKD had significantly lower amounts of K1 measured in liver, spleen and heart and higher levels of MK-4 measured in kidney cortex and medulla. All animals treated with high dietary K1 had an increase in tissue levels of both K1 and MK-4; however, the relative increase in K1 differed suggesting that the conversion of K1 to MK-4 may be a regulated/limiting process in some tissues. There was a decrease in the thoracic aorta expression of vitamin K recycling (Vkor) and utilization (Ggcx) enzymes, and a decrease in the kidney level of vitamin K1 to MK-4 bioconversion enzyme Ubiad1 in CKD. Conclusion: Taken together, these findings suggest that CKD impacts vitamin K metabolism, and this occurs early in the disease course. Our findings that vitamin K metabolism is altered in the presence of CKD provides further support that sub-clinical vitamin K deficiency may represent a modifiable risk factor for vascular and bone health in this population.


2007 ◽  
Vol 71 (10) ◽  
pp. 1076 ◽  
Author(s):  
F. Turgut ◽  
M. Kanbay ◽  
B. Isik ◽  
A. Akcay

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