Abstract:
:Dysfunction of arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) contribute significantly to morbidity and hospitalization in the dialysis population. Despite advances in endovascular techniques, the incidence of vascular access stenosis remains problematic. Currently, the role of endovascular stent placement in the treatment of vascular access stenosis is poorly defined. This meta-analysis compares the primary patency rates of stenotic vascular access treated with stent placement vs. angioplasty. We searched Medline for English language publications from 1980 through December 2013, along with national conference proceedings and reference lists of all included publications. Inclusion criteria were a measure of primary patency, secondary patency, or access dysfunction. Studies were excluded if they were not in English or if they included pediatric patients. Ten studies with a total of 860 subjects met the inclusion criteria, including six experimental studies and four observational studies. There was significantly higher overall primary patency in those receiving stent placement than in those treated with angioplasty (pooled relative risk [RR] = 0.79; 95% confidence interval [CI]: 0.65-0.96). The estimate did not differ by study design. The effect of treatment differed significantly (p = 0.001) by the type of stents used, however. In studies including nitinol stents (six studies, 678 patients), 6-month patency was significantly better for stent placement than angioplasty (pooled RR = 0.67; 95% CI: 0.54-0.84), whereas there was no significant differences between stent placement and angioplasty in those studies using bare metal stents exclusively (four studies, 182 patients; pooled RR = 1.09; 95% CI: 0.91-1.32). There was significant heterogeneity between studies (I(2) = 70.6%; p < 0.0001). Our results suggest that stent placement may confer an advantage over balloon angioplasty in primary patency of dialysis access stenoses.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Fu N,Joachim E,Yevzlin AS,Shin JI,Astor BC,Chan MRdoi
10.1111/sdi.12314subject
Has Abstractpub_date
2015-05-01 00:00:00pages
311-7issue
3eissn
0894-0959issn
1525-139Xjournal_volume
28pub_type
杂志文章,meta分析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
更新日期:2015-01-01 00:00:00
abstract::The increasing number of patients requiring renal replacement therapy poses a challenge to maintain quality of care in the setting of limited resources. The commonly used modalities include hemodialysis and peritoneal dialysis, and using a "urea-centric" model to increase the clearance of small molecular weight uremic...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2009.00665.x
更新日期:2009-11-01 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
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journal_title:Seminars in dialysis
pub_type: 评论,社论
doi:10.1046/j.1525-139x.2003.03001.x
更新日期:2003-01-01 00:00:00
abstract::Hyperkalemia contributes significantly to high mortality among ESRD patients. Excess intake and inadequate removal are the most common etiologies in HD patients. Although dialysis is the definitive treatment, classical medical therapy must be employed as a temporizing measure to acutely lower serum potassium. Reducing...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12272
更新日期:2014-11-01 00:00:00
abstract::Patients with end-stage renal disease are more likely to suffer from gastrointestinal (GI) problems, including bleeding from upper and lower sources. Peptic ulcer disease is the most common cause of upper GI bleeding, and although there is some debate in the literature regarding whether the frequency of ulcer disease ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12301
更新日期:2015-01-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12031
更新日期:2013-01-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2011.01023.x
更新日期:2012-03-01 00:00:00
abstract::Determining dry weight and assessing extracellular fluid volume in hemodialysis (HD) patients is one of the greatest challenges to practicing nephrologists. The clinical examination has limited accuracy, so different strategies have been investigated to aid in this evaluation. Biochemical markers of volume overload (A...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139x.2004.17112.x
更新日期:2004-01-01 00:00:00
abstract::The author reports a case of a successful retrieval of a stent-graft in a young patient with a femoral dialysis graft. The stent-graft was used to treat a resistant occluded segment of the arterial limb of the graft. However, the stent-graft was inadvertently deployed partially into the superficial femoral artery. The...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2010.00710.x
更新日期:2010-03-01 00:00:00
abstract::Most recent randomized controlled trials (RCTs) have found that hemodialysis graft surveillance combined with preemptive correction of stenosis does not prolong graft survival. Nevertheless, such programs may be justified if they reduce other adverse outcomes or decrease the cost of care. This study tested this hypoth...
journal_title:Seminars in dialysis
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-139X.2005.00102.x
更新日期:2005-11-01 00:00:00
abstract::Peritoneal dialysis (PD) is a markedly underutilized modality for permanent renal replacement therapy in the United States owing to a low rate of patient referral and high rate of patient dropout or transfer to hemodialysis. One cause for patient loss from PD is problematic PD catheters that often are removed rather t...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2006.00148.x
更新日期:2006-03-01 00:00:00
abstract::In the United States, presently there are more than 50,000 patients with end-stage renal disease (ESRD) awaiting a cadaveric kidney and each year less than a quarter receive kidney transplantation. Although the real incidence in unknown, a significant number of these patients die due to lack of dialysis access. While ...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1046/j.1525-139x.2002.00001.x
更新日期:2002-01-01 00:00:00
abstract::The development of many electrolyte disturbances in the ICU can be prevented by attention to the use of intravenous fluids and nutrition. Hyponatremia is a relative contraindication to the use of hypotonic intravenous fluids and hypernatremia calls for the administration of water. Formulae have been devised to guide t...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2006.00212.x
更新日期:2006-11-01 00:00:00
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::Recombinant human erythropoietin (rHuEPO, epoetin) revolutionized the treatment of anemia in patients with chronic kidney disease (CKD) when it was approved for use in the United States in 1989. Among dialysis patients, the mean hemoglobin (Hb) in patients undergoing dialysis rose from 7-8 g/dl prior to 1989 to 11-12 ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18105.x
更新日期:2005-01-01 00:00:00
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
更新日期:2015-05-01 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
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2003.16103.x
更新日期:2003-11-01 00:00:00
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journal_title:Seminars in dialysis
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doi:10.1111/sdi.12706
更新日期:2018-07-01 00:00:00
abstract::Peritoneal dialysis (PD) is a simple, safe, gentle, and efficient renal replacement therapy (RRT) method. It is able to correct acute kidney injury (AKI)-induced metabolic, electrolytic, and acid-base disorders and volume overload both in and out the intensive care unit setting. Some PD modalities, such as high-volume...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2011.00868.x
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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::Severe hypothermia is defined as a core body temperature <28°C and is associated with in-hospital mortality rates of 50% or higher. Delays in rewarming and slower rates of rewarming are the most important prognostic factors associated with increased mortality. Arrhythmias are the most common cause of mortality in pati...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12156
更新日期:2014-05-01 00:00:00
abstract::Increasing the use of arteriovenous fistulae in dialysis patients requires a specific strategy. In order to properly select patients for an arteriovenous fistula (AVF), it is essential that the nephrologist become knowledgeable about the subject and that an organized approach be followed. Both the arterial and venous ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2000.00079.x
更新日期:2000-09-01 00:00:00
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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::A thorough consideration of all factors contributing to successful dialysis access creation is necessary to achieve optimal outcomes. A high bifurcation of the brachial artery (brachioradial variant) occurs in greater than 20% of patients. Dialysis access was created in 22 limbs with this variant--15 fistula, and 7 pr...
journal_title:Seminars in dialysis
pub_type: 杂志文章,收录出版
doi:10.1111/j.1525-139X.2011.00923.x
更新日期:2011-11-01 00:00:00
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
更新日期:2015-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2012.01112.x
更新日期:2013-03-01 00:00:00
abstract::A procedure-related complication is an unanticipated adverse event that requires therapy. In order to analyze frequency and severity of complications in the process of quality assurance, it is useful to have a classification of complications, indicating the type and severity. The Clinical Practice Committee of America...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2007.00318.x
更新日期:2007-07-01 00:00:00
abstract::Elderly ESRD patients often lose functionality when they start dialysis, which may be due to a variety of clinical problems. We recently postulated that intensive (longer and/or more frequent) hemodialysis (HD) may be the ideal strategy to try to prevent these ESRD- and dialysis-related complications, including dialys...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12011
更新日期:2012-11-01 00:00:00