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Acute Kidney Injury and Chronic Kidney Disease
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Lynne Sykes, Ibrahim Ali, Philip A. Kalra
Haemodialysis circuit:DialyserDialysate − solution of ultrapure water and various concentrations of electrolytes.Anticoagulation − prevents clotting in the extracorporeal circuit.Vascular access − removes blood from the patient and have it returned after passing through the dialyser.
Complications of hemodialysis access
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Mia Miller, Prakash Jayanthi, William Oppat
With increased prevalence of ESRD, the associated healthcare expenditure also continues to increase. Medicare fee-for-service spending for ESRD beneficiaries has steadily increased yearly, with over 30 billion in 2013 accounting for 7.1% of the overall Medicare paid claims costs.3 These costs include cardiovascular issues, infection, and, importantly, vascular access-related costs, which include complications and maintenance. Given the substantial representation of vascular access-related costs, it becomes ever more important to gain earlier recognition of the complications to prevent further depletion of Medicare resources. Here, we discuss complications associated with hemodialysis access creation, with appropriate diagnosis and management. We hope to provide education to healthcare providers to improve expertise and optimize management of vascular access, thereby decreasing complications.
Point-of-Care Ultrasound (POCUS)
Published in John McCafferty, James M Forsyth, Point of Care Ultrasound Made Easy, 2020
Vascular access is a common invasive procedure which hospital patients undergo. This may be a peripheral venous cannula, a midline or a peripherally inserted central catheter (PICC line) placement if more prolonged venous access is required (see Figure 2.7). In the critical care setting, a central venous line placement is often required.
Prognosis and risk factors for cardiac valve calcification in Chinese end-stage kidney disease patients on combination therapy with hemodialysis and hemodiafiltration
Published in Renal Failure, 2022
Jian-qiong Xiong, Xue-mei Chen, Chun-ting Liang, Wen Guo, Bai-li Wu, Xiao-gang Du
In total, 293 patients underwent regular hemodialysis for 4 h twice a week and online hemodiafiltration for 4 h once a week using a Helixone Haemodlafilter FX 800 (Surface Are: 1.8 m2) or NIPRO Hollow fiber dialyzer FB-150U (Surface Area: 1.5 m2) combined with intermittent hemoperfusion once every month using the Jafron HA130 disposable hemoperfusion system. Blood purification was conducted on a Fresenius Medical Care 4008s or GAMBRO AK96 hemodialysis machine. Autogenous arteriovenous fistulas were the preferred route for vascular access followed by arteriovenous grafts or venous catheters. The patient’s blood was extracted at a blood flow rate of 230–280 mL/min. All dialysate calcium concentrations were not greater than 1.25–1.50 mmol/L. All patients received conventional drug therapy, such as antihypertensive treatment with calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium and phosphorus-regulating treatment with a calcium-containing phosphorous binder or alfacalcidol tablets, anti-anemia treatment with iron preparations or recombinant human erythropoietin (EPO).
Long-Term Management of Vascular Access Ports in Nonhuman Primates Used in Preclinical Efficacy and Tolerability Studies
Published in Journal of Investigative Surgery, 2020
Lucas A. Mutch, Samuel T. Klinker, Jody J. Janecek, Melanie N. Niewinski, Rachael M. Z. Lee, Melanie L. Graham
Totally implantable vascular access ports facilitate effective long-term administration of fluids, contrast, drugs, parenteral nutrition, and biological products as well as routine blood collection. Choosing an appropriate and reliable infusion method limits the number of unnecessary procedures and can improve outcomes [30]. VAP use in NHPs eliminates the problems introduced by disposable, short-term use, or tethered catheters passing through the skin with external components that must be protected with a jacket (or equivalent barrier) to avoid entanglement, dislodgement, or pull-out since many animals will attempt to remove them. NHPs are characteristically curious and dexterous such that externalized catheters are particularly at risk for both infection and displacement. The entirely subcutaneous implantation of the VAP improves the wellbeing of animals by reducing infectious risks and eliminating restraint or tethering so that animals can exercise control in their care as well as participate fully in social groups and activities.
Hepcidin and diabetes are independently related with soluble transferrin receptor levels in chronic dialysis patients
Published in Renal Failure, 2019
Luís Belo, Susana Rocha, Maria João Valente, Susana Coimbra, Cristina Catarino, Elsa Bronze-da-Rocha, Petronila Rocha-Pereira, Maria do Sameiro-Faria, José Gerardo Oliveira, José Madureira, João Carlos Fernandes, Vasco Miranda, Alice Santos-Silva
Patients were under online hemodiafiltration (HDF; 87.8%) or under high-flux hemodialysis (12.2%) treatment (Table 1), and used high-flux polysulfone FX-class dialyzers (1.4–2.2 m2) of Fresenius (Bad Homburg, Germany). The most prevalent vascular access used by patients was arteriovenous fistula (80.9%), followed by central venous catheter (14.2%) and arteriovenous graft (4.9%). Causes of renal failure in the studied patients were diabetes mellitus (n = 87), arterial hypertension (n = 34), glomerulonephritis (n = 18), polycystic renal disease (n = 17), other diseases (n = 39), and uncertain etiology (n = 51).