Abstract:
:Antibiotic prophylaxis has been employed to reduce the risk of infection. Many reports have documented the role of prophylactic antibiotics on the subsequent development of infection in patients undergoing surgical as well as a variety of percutaneous interventions including cardiac, vascular, biliary, genitourinary, and drainage of fluid collections. While prophylactic antibiotics can be critically important for certain procedures, their use can be associated with allergic reactions (including anaphylaxis), development of bacterial resistance, and increased costs of medical care. In this analysis, we report the incidence of clinical infection following minimally invasive interventions for dialysis access procedures. Hemodialysis (HD) and peritoneal dialysis (PD) patients undergoing consecutive percutaneous interventions (n = 3162) for HD and PD access were included in this study. Procedure-related clinical infection was defined as the presence of fever/chills, tenderness, erythema, swelling within 72 hours postprocedure. The procedures included percutaneous balloon angioplasty (arterial and venous) [n = 2078 (AVF = 1310; AVG = 768)], venography for vascular mapping (n = 110), endovascular stent insertion (n = 26), intravascular coil placement (n = 31), thrombectomy for an arteriovenous fistula (n = 106), thrombectomy for an arteriovenous graft (n = 110), tunneled hemodialysis catheter (TDC) insertion and exchange (n = 283), TDC removal (n = 160), and insertion of accidentally extruded TDC through the same exit site (n = 9). There were 260 peritoneal dialysis catheter insertions and 15 repositioning procedures. Only patients undergoing TDC insertion for accidentally extruded catheter and PD catheter placement received antibiotic prophylaxis within 1-2 hours before the procedure. Extruded TDC received 1 g of cefazolin while PD catheter insertion had 1 g of intravenous vancomycin. Povidone iodine was used for skin antisepsis in all cases. One patient (0.04%) postangioplasty and one patient (0.3%) after tunneled catheter placement developed clinical infection manifested by fever, chills, and malaise within 24 hours of the procedure. Both required hospitalization. Patient with angioplasty was a diabetic with an arteriovenous graft while TDC insertion was performed in a patient with advanced HIV. Percutaneous dialysis access procedure infections are generally low and might not warrant routine administration of antibiotic prophylaxis for all cases except for PD catheters and accidentally extruded TDC.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Salman L,Asif Adoi
10.1111/j.1525-139X.2009.00607.xsubject
Has Abstractpub_date
2009-05-01 00:00:00pages
297-9issue
3eissn
0894-0959issn
1525-139Xpii
SDI607journal_volume
22pub_type
杂志文章abstract::Parenteral iron is used to restore the body's iron pool before and during erythropoiesis-stimulating agent (ESA) therapy; together these agents form the backbone of anemia management in end-stage renal disease (ESRD) patients undergoing hemodialysis. ESRD patients receiving chronic intravenous iron products, which exc...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/sdi.12732
更新日期:2019-01-01 00:00:00
abstract::The use of stents has been steadily increasing in the management of dialysis access dysfunction. The purpose of this report was to review the use of covered stents in failed forearm fistulas and describe a case of the use of a small caliber forearm covered stent in a early failed forearm fistula that allowed dialysis ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00473.x
更新日期:2009-01-01 00:00:00
abstract::Anabolic steroids have been used for the treatment of the anemia of chronic renal failure for more than 25 years. Due to concerns over adverse effects, their use historically has been limited to nandrolone decanoate given to men, usually over age 50, who have intact kidneys. The introduction of epoetin alfa in 1989 ha...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2000.00011.x
更新日期:2000-01-01 00:00:00
abstract::Over the last 10 years an increasing number of patients worldwide have started dialysis or had transplantation. Many are elderly with complex comorbid conditions. Registries across the world all show a rapid and dramatic increase in the number of older patients accepted for renal replacement therapy. In addition, the ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1046/j.1525-139x.2002.00028.x
更新日期:2002-03-01 00:00:00
abstract::Iodinated contrast agents are well tolerated in ESRD patients. Certain types of ICM, i.e., LOCM and the nonionic agents are associated with better safety profiles. Current available evidence, although not optimal, does not support the need for additional hemodialysis for ICM removal to preserve residual renal function...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12268
更新日期:2014-11-01 00:00:00
abstract::Recent experimental and clinical studies suggest the possible utility of niacin (nicotinic acid, vitamin B3) and its metabolite nicotinamide as a means of lowering phosphate levels in dialysis patients via direct inhibition of the Na-Pi-2b sodium-dependent phosphate co-transporter in the GI tract. While the possibilit...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2008.00426.x
更新日期:2008-05-01 00:00:00
abstract::The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients o...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12671
更新日期:2018-03-01 00:00:00
abstract::Parathyroidectomy (PTX) remains an important intervention for dialysis patients with poorly controlled secondary hyperparathyroidism (SHPT), though there are only retrospective and observational data that show a mortality benefit to this procedure. Potential consequences that we seek to avoid after PTX include persist...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12833
更新日期:2019-11-01 00:00:00
abstract::For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12691
更新日期:2018-05-01 00:00:00
abstract::Dialysis patients are at high risk for fracture, with published rates in excess of a 20% probability of fracture over the next 10 years of dialysis. Unfortunately, there is no accepted methodology for quantifying this risk in advance of the first fracture; conventional bone densitometry performs unreliably in this rol...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2010.00817.x
更新日期:2011-01-01 00:00:00
abstract::Arteriovenous fistula (AVF) failure is mainly due to venous stenosis characterized by significant amount of intima-media thickening (IMT), probably in the presence of negative (inward) remodeling. Our hypothesis is that the longitudinal changes in wall shear stress (WSS) within different configurations of AVF can infl...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12045
更新日期:2013-07-01 00:00:00
abstract::The prevalence of arrhythmia has increased in hemodialysis (HD) patients and the most frequent is atrial fibrillation (AF). It was reported that the amount of epicardial fat tissue (EFT) in the population without renal disease is closely related to AF. In the present study of ours, the relation between EFT thickness a...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12901
更新日期:2020-09-01 00:00:00
abstract::Dialysate leakage represents a major noninfectious complication of peritoneal dialysis (PD). An exit-site leak refers to the appearance of any moisture around the PD catheter identified as dialysate; however, the spectrum of dialysate leaks also includes any dialysate loss from the peritoneal cavity other than via the...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2001.00014.x
更新日期:2001-01-01 00:00:00
abstract::Growing evidence has been gathered over the last 15 years regarding the role of nontraditional or uremia-related risk factors in the pathogenesis of atherosclerosis in subjects with renal failure. Among those factors, dyslipidemia, inflammation, hyperhomocysteinemia, and oxidant stress have been extensively studied. H...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2003.16031.x
更新日期:2003-03-01 00:00:00
abstract::Cardiac resynchronization therapy with or without a defibrillator (CRT(D)) and implantable cardioverter defibrillator (ICD) may reduce the risk of arrhythmia or heart failure-specific mortality and improves the prognosis of patients with chronic kidney disease (CKD) or dialysis. The aim of this study was to perform a ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12937
更新日期:2020-12-09 00:00:00
abstract::Congestive heart failure (CHF) is highly prevalent in patients on renal replacement therapy and is a leading cause of death in such patients. Several studies suggest that therapeutic agents for the treatment of CHF, particularly angiotensin converting enzyme inhibitors and beta-blockers, are underused in end-stage ren...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2007.00313.x
更新日期:2007-09-01 00:00:00
abstract::Patients undergoing chronic renal replacement therapy have a high incidence of dyslipidemia. In general, there are increased concentrations of triglyceride-rich apolipoprotein B-containing particles. These elevations lead to increased levels of non-high-density lipoprotein (HDL) levels. This pattern is further modifie...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2006.00117.x
更新日期:2006-01-01 00:00:00
abstract::With the increased number of renal transplants being performed in the United States, there are also increasing numbers of early and long-term allograft failures. Patients with failed allografts require reentry into the end-stage renal disease (ESRD) system. If an allograft is producing little in the way of morbidity, ...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/j.1525-139X.2005.18306.x
更新日期:2005-05-01 00:00:00
abstract::The role of peritoneal dialysis (PD) as a modality in renal replacement therapy has been well established. In this article we review various aspects in the evolution of PD, with special emphasis on adequacy. Until the late 1950s PD was still considered as a last resort in the treatment of terminal uremia. The introduc...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2001.00071.x
更新日期:2001-07-01 00:00:00
abstract::Catheter recirculation (CR) occurs when blood returning from the venous limb of the catheter re-enters the arterial limb of the catheter without passage through the circulation. Adequacy of dialysis is influenced by the degree of access recirculation. In this study we evaluate factors influencing the degree of dialysi...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00442.x
更新日期:2008-05-01 00:00:00
abstract::Home dialysis (home HD or home PD) remains underutilized in most jurisdictions. Physicians, advanced-practice nurses, and policy makers working with chronic kidney disease populations can provide insights into patient, healthcare professional, and system-level barriers to home dialysis selection by suitable patients. ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12183
更新日期:2014-03-01 00:00:00
abstract::The elderly represent the fastest growing segment of incident patients entering end-stage renal disease (ESRD). Increasingly, social scientists and caregivers are faced with changing models of care, which will challenge traditional patterns of patient acceptance into costly medical therapies. This paper analyzes the o...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12015
更新日期:2012-11-01 00:00:00
abstract::The increased frequency of cardiovascular disease observed in hemodialysis patients is secondary to the combination of many traditional (age, male sex, hypertension, smoking, diabetes mellitus, and dyslipidemia) and novel and uremia-related (inflammation, uremic toxins, adipokine imbalance, coagulation disorders, prot...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/sdi.12345
更新日期:2015-05-01 00:00:00
abstract::It has been clearly established that critically ill patients with sepsis require prompt fluid resuscitation. The optimal amount of fluid and when to taper this resuscitation is less clear. There is a growing evidence that fluid overload leads to acute kidney injury, and increased morbidity and mortality. A clinician's...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/sdi.12753
更新日期:2019-01-01 00:00:00
abstract::The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.0894-0959.2004.17329.x
更新日期:2004-07-01 00:00:00
abstract::Numerous designs for tunneled hemodialysis catheter have been developed in an effort to improve catheter function and survival. In this prospective randomized controlled study, 97 patients were randomized into the palindrome catheter group (PC, n = 47) and step-tip catheter group (SC, n = 50). Demographic characterist...
journal_title:Seminars in dialysis
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-139X.2012.01054.x
更新日期:2012-09-01 00:00:00
abstract::Managing an end-stage renal disease (ESRD) patient is complex and presents many ethical challenges for the physician. Ownership of dialysis facilities has shifted over the past decade from largely nonprofit organizations to large companies whose shareholders are primarily interested in the profitability of their inves...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139x.2004.17102.x
更新日期:2004-01-01 00:00:00
abstract::Hemodialysis patients with failed upper extremity (arm) access sites comprise 5-10% of the dialysis population. In these patients, arm vessels are either unsuitable for access placement due to trauma or peripheral vascular disease, or have been exhausted following dialysis usage. Synthetic grafts in the lower extremit...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2009.00613.x
更新日期:2009-09-01 00:00:00
abstract::Nephrogenic systemic fibrosis has now been linked to gadolinium-based contrast exposure in those with compromised kidney function. When present, symptoms can be quite devastating for the patient including severe pain and immobility. Unfortunately there is a lack of a universally effective therapy at this time and the ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00407.x
更新日期:2008-03-01 00:00:00
abstract::Renal osteodystrophy (ROD) is a bone disorder that occurs in chronic kidney disease (CKD) patients and is associated with 2- to 14-fold increased fracture risk compared to the general population. Risk of fractures is also increased in kidney transplant recipients especially within the first 5 years after transplantati...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12423
更新日期:2015-11-01 00:00:00