The risk of sedation/analgesia in hemodialysis patients undergoing interventional procedures.

Abstract:

:Data derived from a large cohort of hemodialysis patients (12,896) undergoing dialysis access maintenance procedures being performed by interventional nephrologists were analyzed to determine the safety of sedation/analgesia (S/A) in a freestanding facility. Data collected included patient demographics, procedures performed, time of procedures, drugs used, doses used, and complications that occurred. Four high-risk groups were identified based upon age, pulmonary status, and over all physical status. These were compared to the total cohort. Midazolam, fentanyl, or a combination of the two were used. Within the total cohort of patients, midazolam alone was used most commonly (94.7%). The total mean dose of midazolam when used alone was 3.4 mg. The dosages used in the high-risk groups tended to be only slightly lower (3-3.2 mg). This setting appears to be safe for hemodialysis patients, even those in high-risk subgroups having these types of procedures. The types of drugs and the dosages that are commonly used do not appear to be associated with an unacceptable risk to the hemodialysis patient. A nephrologist that is not specialty trained in anesthesia is able to provide S/A safely in a freestanding facility.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Beathard GA,Urbanes A,Litchfield T,Weinstein A

doi

10.1111/j.1525-139X.2011.00844.x

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

97-103

issue

1

eissn

0894-0959

issn

1525-139X

journal_volume

24

pub_type

杂志文章
  • Antibiotic prophylaxis: is it needed for dialysis access procedures?

    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, ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2009.00607.x

    authors: Salman L,Asif A

    更新日期:2009-05-01 00:00:00

  • Epidemiology and demographic aspects of treated end-stage renal disease in the elderly.

    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

    authors: Krishnan M,Lok CE,Jassal SV

    更新日期:2002-03-01 00:00:00

  • Laughter and humor therapy in dialysis.

    abstract::Laughter and humor therapy have been used in health care to achieve physiological and psychological health-related benefits. The application of these therapies to the dialysis context remains unclear. This paper reviews the evidence related to laughter and humor therapy as a medical therapy relevant to the dialysis pa...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12194

    authors: Bennett PN,Parsons T,Ben-Moshe R,Weinberg M,Neal M,Gilbert K,Rawson H,Ockerby C,Finlay P,Hutchinson A

    更新日期:2014-09-01 00:00:00

  • Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients?

    abstract::Early versus later start of dialysis is still a matter of debate. Low-protein diets have been used for many decades to delay dialysis initiation. Protein-restricted diets (0.3-0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological tre...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12132

    authors: Aparicio M,Bellizzi V,Chauveau P,Cupisti A,Ecder T,Fouque D,Garneata L,Lin S,Mitch W,Teplan V,Yu X,Zakar G

    更新日期:2013-11-01 00:00:00

  • The impact of arteriovenous fistulae on the myocardium: the impact of creation and ligation in the transplant era.

    abstract::Cardiac hypertrophy is a relatively common complication seen in patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD). Moreover, cardiac hypertrophy is even more frequently seen in patients with ESRD who have an arteriovenous (AV) access. There has been substantial evidence pertaining ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12313

    authors: Duque JC,Gomez C,Tabbara M,Alfonso CE,Li X,Vazquez-Padron RI,Asif A,Lenz O,Briones PL,Salman LH

    更新日期:2015-05-01 00:00:00

  • Catheter thrombosis.

    abstract::Catheter malfunction due to poor flow is a common problem. When it occurs early, the cause is generally technical. Late occurrences are most often related to thrombus formation. Several types of thrombus may be seen, differing by location and supposed mechanism of formation. The most common offender, however, is the f...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2001.00109.x

    authors: Beathard GA

    更新日期:2001-11-01 00:00:00

  • Impact of drugs on intradialytic hypotension: Antihypertensives and vasoconstrictors.

    abstract::Intradialytic hypotension (IDH) is a common complication of hemodialysis and is associated with numerous adverse outcomes including cardiovascular events, inadequate dialysis, loss of vascular access, and death. It is estimated that approximately 20%-30% of all dialysis sessions are affected by IDH. In seeking ways to...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12633

    authors: Chang TI

    更新日期:2017-11-01 00:00:00

  • Patency and Complications of Translumbar Dialysis Catheters.

    abstract::Translumbar tunneled dialysis catheter (TLDC) is a temporary dialysis access for patients exhausted traditional access for dialysis. While few small studies reported successes with TLDC, additional studies are warranted to understand the short- and long-term patency and safety of TLDC. We conducted a retrospective ana...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12358

    authors: Liu F,Bennett S,Arrigain S,Schold J,Heyka R,McLennan G,Navaneethan SD

    更新日期:2015-07-01 00:00:00

  • Niacin and related compounds for treating hyperphosphatemia in dialysis patients.

    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

    authors: Berns JS

    更新日期:2008-05-01 00:00:00

  • Lipid abnormalities associated with end-stage renal disease.

    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

    authors: Liu J,Rosner MH

    更新日期:2006-01-01 00:00:00

  • Baxter Aurora dialysis system.

    abstract::With the recent focus on the benefits of more frequent dialysis, the Baxter Aurora dialysis system provides maximum flexibility for therapy prescription, including short daily treatments, long nocturnal treatments, hemodialysis, hemofiltration, and online hemodiafiltration, all in a compact, reliable, easy to use syst...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.0894-0959.2004.17215.x

    authors: Kelly TD

    更新日期:2004-03-01 00:00:00

  • Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta-analysis.

    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

    authors: Liu Y,Sun JY,Zhu YS,Li ZM,Li KL,Wang RX

    更新日期:2020-12-09 00:00:00

  • When should iron supplementation in dialysis patients be avoided, minimized or withdrawn?

    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

    authors: Rostoker G

    更新日期:2019-01-01 00:00:00

  • Cardiovascular abnormalities and hypertension in the elderly dialysis patient.

    abstract::Elderly individuals comprise an ever-increasing proportion of patients on renal replacement therapy (RRT). As in younger patients, cardiovascular events are the major cause of death in the elderly on RRT, although the relative proportion succumbing to cardiovascular events is similar to that in young patients. An impo...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2002.00037.x

    authors: Dikow R,Zeier M,Ritz E

    更新日期:2002-03-01 00:00:00

  • Automated intravascular access pressure surveillance reduces thrombosis rates.

    abstract::Although monitoring of vascular accesses by physical examination is nearly as sensitive as surveillance measurements by vascular access pressure when performed by examiners, the frequency of examinations is limited by time. We developed intravascular access pressure surveillance as a surrogate to physical examination....

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2010.00755.x

    authors: Zasuwa G,Frinak S,Besarab A,Peterson E,Yee J

    更新日期:2010-09-01 00:00:00

  • Dialysis in pregnant women with chronic kidney disease.

    abstract::Pregnancy occurs uncommonly in women with chronic kidney disease (CKD) and fetal outcome tends to be poor, with high rates of prematurity and mortality. Dialysis, by complementing residual renal function, may improve fetal outcome in pregnant women with CKD. Although there are no prospective or randomized trials that ...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1046/j.1525-139x.2003.16084_1.x

    authors: Shemin D

    更新日期:2003-09-01 00:00:00

  • Health-related quality of life in nephrology research and clinical practice.

    abstract::Physical, psychosocial, and lifestyle disturbances, along with physical and emotional symptoms, have been shown to impact the health-related quality of life (HRQOL) of those dependent on renal replacement therapy. The value of HRQOL measurement as a tool to improve clinical care has been recognized by patients, clinic...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.18206.x

    authors: Unruh ML,Weisbord SD,Kimmel PL

    更新日期:2005-03-01 00:00:00

  • Surgical Management of Complications with Peritoneal Dialysis.

    abstract::This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. Th...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12538

    authors: Ratajczak A,Lange-Ratajczak M,Bobkiewicz A,Studniarek A

    更新日期:2017-01-01 00:00:00

  • Sympathetic nervous system function and dysfunction in chronic hemodialysis patients.

    abstract::Adequate sympathetic nervous system activation is essential for the compensatory mechanisms of blood pressure maintenance during the hemodialysis (HD) procedure. Chronic sympathetic nervous system overactivity, however, may lead to the development of hypertension and cardiovascular disease in HD patients. The present ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12093

    authors: Rubinger D,Backenroth R,Sapoznikov D

    更新日期:2013-05-01 00:00:00

  • Conservative treatment of the uremic syndrome.

    abstract::In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2009.00600.x

    authors: Vanholder R,Argilés A,Beige J,Brunet P,Drüeke TB,Fliser D,Herget-Rosenthal S,Hörl WH,Jörres A,Perna A,Rodriguez-Portillo M,Spasovski G,Stegmayr B,Stenvinkel P,Wanner C,Wiecek A,Massy ZA

    更新日期:2009-07-01 00:00:00

  • Clinical waste generation from renal units: implications and solutions.

    abstract::The treatment of end-stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.00078.x

    authors: Hoenich NA,Levin R,Pearce C

    更新日期:2005-09-01 00:00:00

  • Dialysis membrane and modality in acute renal failure: understanding discordant meta-analyses.

    abstract::Meta-analyses of the published literature are increasingly being used, allowing similar clinical trials to be combined quantitatively, thereby increasing the precision of the estimation of treatment effect. Four meta-analyses were recently published comparing the impact of dialysis membranes or dialysis modality on cl...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1046/j.1525-139x.2003.16071.x

    authors: Teehan GS,Liangos O,Lau J,Levey AS,Pereira BJ,Jaber BL

    更新日期:2003-09-01 00:00:00

  • Iron and infection in hemodialysis patients.

    abstract::Intravenous iron is an important component of the treatment of anemia of end-stage renal disease (ESRD), but it is biologically plausible that iron could increase the risk of infection through impairment of neutrophil and T-cell function and promotion of microbial growth. Any such increase in risk would be particularl...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12168

    authors: Ishida JH,Johansen KL

    更新日期:2014-01-01 00:00:00

  • Thigh grafts: a preferable alternative to catheters when upper extremity access sites are exhausted.

    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

    authors: Abreo KD,Ram SJ

    更新日期:2009-09-01 00:00:00

  • Therapeutic plasma exchange for renal-related conditions in the elderly: ten years experience in one center.

    abstract::The elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal i...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2011.01027.x

    authors: Hayes JS,Balogun RA,Chang J,Abdel-Rahman EM

    更新日期:2012-03-01 00:00:00

  • A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis.

    abstract:INTRODUCTION:Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. METHODS:Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end-to-side variety. Parameters st...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12907

    authors: Jothi S,Kg H,Lesley N,Vijayan M,Haridas Anupama S,Mathew M,Parthasarathy R,Sundarajan S,P N,Kumaraswamy L,Abraham G

    更新日期:2020-09-01 00:00:00

  • Antidiabetic Therapy in End-Stage Renal Disease.

    abstract::There has been substantial growth in the variety of available antidiabetic agents during the last decade and a half. The role of these newer agents in patients with diabetes and end-stage renal disease (ESRD) population, and their relative benefits and risks in this population compared to patients without ESRD are not...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12368

    authors: Boyle SM,Simon B,Kobrin SM

    更新日期:2015-07-01 00:00:00

  • Is surgical salvage of arteriovenous grafts feasible after unsuccessful percutaneous mechanical thrombectomy?

    abstract::Treatment of thrombosed dialysis ateriovenous (AV) grafts in the radiology interventional suite requires percutaneous mechanical thrombectomy, along with angioplasty of the underlying stenotic lesion. We analyzed the anatomic reasons for unsuccessful percutaneous thrombectomy of AV grafts, and assessed the feasibility...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2007.00397.x

    authors: Maya ID,Smith T,Young CJ,Allon M

    更新日期:2008-03-01 00:00:00

  • Doppler ultrasound: a powerful tool for vascular access surveillance.

    abstract::National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines recommend Doppler ultrasound (DU) for surveillance of vascular access (VA), but trials have not been unanimous about its benefit on VA patency. The aim of this study was to evaluate the accuracy of DU for patency, as well as t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12334

    authors: Guedes Marques M,Ibeas J,Botelho C,Maia P,Ponce P

    更新日期:2015-03-01 00:00:00

  • In-center hemodialysis education: Challenges and innovations in training of fellows in nephrology.

    abstract::The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12668

    authors: Moist LM,Lindsay RM

    更新日期:2018-03-01 00:00:00