Dialysis vascular access management by interventional nephrology programs at University Medical Centers in the United States.

Abstract:

:The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Vachharajani TJ,Moossavi S,Salman L,Wu S,Dwyer AC,Ross J,Dukkipati R,Maya ID,Yevzlin AS,Agarwal A,Abreo KD,Work J,Asif A

doi

10.1111/j.1525-139X.2011.00985.x

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

564-9

issue

5

eissn

0894-0959

issn

1525-139X

journal_volume

24

pub_type

杂志文章
  • 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

  • The psychiatric landscape of withdrawal.

    abstract::Withdrawal from dialysis is an appropriate decision for situations in which the burdens of treatment outweigh the benefits. Alternately, it can be viewed as a public health problem and suicide equivalent that contributes to the high mortality of end-stage renal disease (ESRD). More than one in five deaths of patients ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.18201.x

    authors: Cohen LM,Germain MJ

    更新日期:2005-03-01 00:00:00

  • Consolidation in dialysis Markets-Causes, consequences, and the role of policy.

    abstract::The dialysis industry is one of the most highly concentrated healthcare sectors in the United States. Despite decades of growth in the number of patients with end-stage renal disease and in the size of dialysis markets, two large dialysis organizations currently care for more than two-thirds of the dialysis population...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12855

    authors: Saeed MK,Ho V,Erickson KF

    更新日期:2020-01-01 00:00:00

  • How I do it: directional atherectomy for in-stent restenosis of a PTFE arteriovenous graft.

    abstract::We describe the use of directional atherectomy (DA) to restore patency of a thrombosed polytetrafluoroethylene arteriovenous graft with an in-stent restenosis at the venous anastomosis. Technically, the procedure described is not an atherectomy per se, but rather the removal of fibrosis and intimal hyperplasia with sh...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2007.00418.x

    authors: Yevzlin AS,Guttormsen B,Chan MR,Gimelli G

    更新日期:2008-05-01 00:00:00

  • Blood pressure control in conventional hemodialysis.

    abstract::Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12741

    authors: Georgianos PI,Agarwal R

    更新日期:2018-11-01 00:00:00

  • Role of advanced glycation endproducts and potential therapeutic interventions in dialysis patients.

    abstract::It has been nearly 100 years since the first published report of advanced glycation end products (AGEs) by the French chemist Maillard. Since then, our understanding of AGEs in diseased states has dramatically changed. Especially in the last 25 years, AGEs have been implicated in complications related to aging, neurod...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2012.01081.x

    authors: Mallipattu SK,He JC,Uribarri J

    更新日期:2012-09-01 00:00:00

  • Dialysis cannot be dosed.

    abstract::Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot be adjusted to control the levels of these solutes. The current solution to this problem is to define an adequate dose of dialysis on the basis of fr...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2011.00979.x

    authors: Meyer TW,Sirich TL,Hostetter TH

    更新日期:2011-09-01 00:00:00

  • A novel technique for tethered dialysis catheter removal using the laser sheath.

    abstract::Traction and cutdown techniques can successfully remove a tunneled dialysis catheter (TDC) in a great majority of patients. However, these methods may not be successful in patients with catheters that are tethered or attached to the central veins or the atrium. A forceful application of traction can lead to catheter b...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2009.00646.x

    authors: Carrillo RG,Garisto JD,Salman L,Merrill D,Asif A

    更新日期:2009-11-01 00:00:00

  • Sonography of Arteriovenous Fistulas and Grafts.

    abstract::Arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) are the vascular accesses of choice for long-term hemodialysis. Strategies to establish and maintain functioning AVFs and AVGs are essential. In addition to clinical evaluation, ultrasound plays a critical role in the evaluation and maintenance of AVFs and ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12599

    authors: Pietryga JA,Little MD,Robbin ML

    更新日期:2017-07-01 00:00:00

  • Bullous skin lesions in a patient undergoing chronic hemodialysis.

    abstract::Porphyria cutanea tarda (PCT) is a vesiculobullous skin disorder characterized by a defect in heme biosynthesis. Reduced activity of the hepatic enzyme uroporphyrinogen decarboxylase (URO-D) results in accumulation of photosensitive porphyrins; this ultimately leads to the skin fragility and blistering that is charact...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2009.00672.x

    authors: Ryali ME,Whittier WL

    更新日期:2010-01-01 00:00:00

  • Euvolemia-A critical target in the management of acute kidney injury.

    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

    authors: Colbert GB,Szerlip HM

    更新日期:2019-01-01 00:00:00

  • Cardiovascular disease in chronic renal failure: pathophysiologic aspects.

    abstract::Cardiovascular complications are the leading cause of mortality in patients with end-stage renal disease (ESRD). The excess cardiovascular risk and mortality is already demonstrable in early renal disease and in patients with chronic renal failure (CRF), with the highest relative risk of mortality in the youngest pati...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2003.16023.x

    authors: London GM

    更新日期:2003-03-01 00:00:00

  • Withholding and withdrawing renal support in acute kidney injury.

    abstract::Management of critically ill patients with acute kidney injury (AKI) is mainly limited to supportive therapy, with dialysis as one of the main components. Whether or not to offer dialysis and when to withdraw dialysis is a one of the many choices physicians face in daily clinical practice. Withholding or withdrawing r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2011.00832.x

    authors: Claure-Del Granado R,Mehta RL

    更新日期:2011-03-01 00:00:00

  • Retrospective analysis of catheter recirculation in prevalent dialysis patients.

    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

    authors: Moossavi S,Vachharajani TJ,Jordan J,Russell GB,Kaufman T,Moossavi S

    更新日期:2008-05-01 00:00:00

  • Endotoxemia in end-stage kidney disease.

    abstract::Chronic unexplained inflammation remains a prevalent and clinically significant problem for patients with end-stage kidney disease (ESKD), especially in the dialysis population. The causes of persistent inflammation are likely to be multifactorial, but the underlying mechanisms remain to be elucidated. Endotoxins are ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12280

    authors: Wong J,Vilar E,Farrington K

    更新日期:2015-01-01 00:00:00

  • Doing More Than Caring About Quality.

    abstract::The treatment of chronically ill patients with end stage renal disease (ESRD) receiving dialysis therapies has advanced greatly over the years and accomplished many successes in prolonging the life of patients with ESRD, yet has had considerable failures due to the inability to compensate for all functions of the kidn...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12471

    authors: Maddux FW

    更新日期:2016-03-01 00:00:00

  • Are dialysate sodium levels too high?

    abstract::Universal lower dialysate [Na+] is often advocated as a means of improving the dire cardiovascular plight of our dialysis patients. However, there is evidence associating lower dialysate [Na+] and increased morbidity and mortality especially in frailer patients, probably as a result of more frequent intra-dialytic hyp...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2012.01072.x

    authors: Marshall MR,Dunlop JL

    更新日期:2012-05-01 00:00:00

  • Dialysate leaks in peritoneal dialysis.

    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

    authors: Leblanc M,Ouimet D,Pichette V

    更新日期:2001-01-01 00:00:00

  • Improving access to renal transplantation.

    abstract::Kidney transplantation is the treatment of choice for most patients with end-stage renal disease (ESRD), with success rates greater than were envisioned as recently as a decade ago. Unfortunately this trend has created unprecedented demand for transplantable organs and new challenges for those desiring transplantation...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.00093.x

    authors: Gaston RS

    更新日期:2005-11-01 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

  • Iatrogenic Baclofen Neurotoxicity in ESRD: Recognition and Management.

    abstract::Baclofen is an oral derivative of gamma-aminobutyric acid (GABA) used to treat muscular spasticity from disorders of the central nervous system. However, it is also being used for a variety of other conditions such as musculoskeletal pain, myoclonus, and alcohol withdrawal. The elimination of baclofen is heavily depen...

    journal_title:Seminars in dialysis

    pub_type: 信件

    doi:10.1111/sdi.12400

    authors: Roberts JK,Westphal S,Sparks MA

    更新日期:2015-09-01 00:00:00

  • Management of hyperkalemia in dialysis patients.

    abstract::Hyperkalemia is common in patients with end-stage renal disease, and may result in serious electrocardiographic abnormalities. Dialysis is the definitive treatment of hyperkalemia in these patients. Intravenous calcium is used to stabilize the myocardium. Intravenous insulin and nebulized albuterol lower serum potassi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00312.x

    authors: Putcha N,Allon M

    更新日期:2007-09-01 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

  • Eliminating the need for routine monthly postdialysis serum urea nitrogen measurement: A method for monitoring Kt/V and normalized protein catabolic rate using conductivity determined dialyzer clearance.

    abstract::Many dialysis machines can compute dialyzer sodium clearances at multiple time points during a dialysis treatment using conductivity. For a given treatment, the average dialyzer sodium clearance (K), when combined with treatment time (t), and the estimated urea distribution volume (V, usually based on either anthropom...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12750

    authors: Daugirdas JT

    更新日期:2018-11-01 00:00:00

  • Decreasing hospitalizations in patients on hemodialysis: Time for a paradigm shift.

    abstract::Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care-sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12675

    authors: Golestaneh L

    更新日期:2018-05-01 00:00:00

  • The pathogenesis of hemodialysis vascular access failure and systemic therapies for its prevention: Optimism unfulfilled.

    abstract::In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12658

    authors: Viecelli AK,Mori TA,Roy-Chaudhury P,Polkinghorne KR,Hawley CM,Johnson DW,Pascoe EM,Irish AB

    更新日期:2018-05-01 00:00:00

  • The relation between epicardial fat tissue thickness and atrial fibrillation ın hemodialysis patients.

    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

    authors: Guzel FB,Altunoren O,Gunes H,Seyithanoglu M,Kerkutluoglu M,Sezal DT,Gungor O

    更新日期:2020-09-01 00:00:00

  • Accuracy of ultrasound in the detection of inflow stenosis of arteriovenous fistulae: results of a prospective study.

    abstract::While vascular ultrasound (US) has been highlighted to detect vascular access stenosis, its accuracy in the identification of inflow stenosis (IS) (anastomosis and/or juxta-anastomotic area) compared with the gold standard (angiography) has not been evaluated. One hundred three consecutive fistulae referred for interv...

    journal_title:Seminars in dialysis

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1525-139X.2009.00693.x

    authors: Salman L,Ladino M,Alex M,Dhamija R,Merrill D,Lenz O,Contreras G,Asif A

    更新日期:2010-01-01 00:00:00

  • Anemia management in cancer patients with chronic kidney disease.

    abstract::Cancer and kidney disease are linked by causality and comorbidities. Observational data show an increased risk of malignancy as renal function declines. Erythropoietin stimulating agents (ESAs), which are the cornerstone therapy for anemia patients with chronic kidney disease and cancer, are associated with increased ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12841

    authors: Latcha S

    更新日期:2019-11-01 00:00:00

  • Comparison of the palindrome vs. step-tip tunneled hemodialysis catheter: a prospective randomized trial.

    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

    authors: Hwang HS,Kang SH,Choi SR,Sun IO,Park HS,Kim Y

    更新日期:2012-09-01 00:00:00