Tunneled Hemodialysis Catheter Removals by Non-Interventional Nephrologists: The University of Mississippi Experience.


:Bedside removal of tunneled hemodialysis catheters (TDC) by noninterventional Nephrologists has not been frequently performed or studied. We performed a retrospective review of bedside TDC removal at the University of Mississippi Medical Center between January, 2010 and June, 2013. We collected data on multiple patients and procedure-related variables, success, and complications rates. Of the 138 subjects, mean age was 50 (±15.9) years, 49.3% were female, 88.2% African American and 41% diabetics. Site of removal was the right internal jugular (IJ) in 76.8%, the left IJ in 15.2%, and the femoral vein in 8% of patients. Exactly 44.9% of removals took place in the outpatient setting. Main indications for the removal were proven bacteremia in 30.4%, sepsis or clinical concerns for infection in 15.2% of the cases, while TDC was no longer necessary in 52.2% of patients. All removals were technically successful and well tolerated, but we observed Dacron "cuff" separation and subcutaneous retention in 6.5% of the cases. There was a significant association between outpatient removal and cuff retention (p = 0.007), but not with the site of removal or operator experience. In this relatively large mixed cohort of inpatients and outpatients, bedside TDC removal was well tolerated with a minimal complication rate.


Semin Dial


Seminars in dialysis


Fülöp T,Rodríguez B,Kosztaczky BA,Gharaibeh KA,Lengvárszky Z,Dossabhoy NR,Tapolyai MB




Has Abstract


2015-09-01 00:00:00












  • Ultrafiltration Rate Clinical Performance Measures: Ready for Primetime?

    abstract::Mounting evidence supports a strong association between fluid management and outcomes among individuals receiving maintenance hemodialysis. The speed of fluid removal during dialysis (ultrafiltration, UF) is a modifiable aspect of fluid management that has attracted recent attention as a potential performance measure ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Flythe JE

    更新日期:2016-11-01 00:00:00

  • Evaluation of potassium levels before hemodialysis access procedures.

    abstract::Few prospective studies have looked at the incidence of hyperkalemia in outpatient hemodialysis access procedures. Our study prospectively evaluated 167 procedures using a preadmit venous blood gas (VBG) and found that 14.3% had moderate or severe hyperkalemia. When the individual procedures were analyzed it was found...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Ross J,DeatherageHand D

    更新日期:2015-01-01 00:00:00

  • Assessing the approach to a thrombosed AV graft.

    abstract::The patency of the vascular access (VA) is a fight for the attending nephrologist. A retrospective observational study was conducted to compare the success rate of surgical versus endovascular technique percutaneous transluminal angioplasty (PTA) for graft thrombosis treatment. Of 3008 patients, 22.1% patients were di...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Ponce P,Carvalho T,Messias H,Neves F,Lisbon VAC Interventional Nephrology Team.

    更新日期:2014-09-01 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


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

    更新日期:2008-05-01 00:00:00

  • Assessment of nutritional status in maintenance hemodialysis patients: A multicenter cross-sectional study in Iran.

    abstract:INTRODUCTION:Protein-energy wasting (PEW) is common in hemodialysis patients and is linked with a high rate of morbidity and mortality. Regarding importance of nutrition in these patients, a recent study was administered to evaluate the nutritional status of hemodialysis patients. MATERIALS:In this cross-sectional stu...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Akhlaghi Z,Sharifipour F,Nematy M,Safarian M,Malekahmadi M,Barkhidarian B,Norouzy A

    更新日期:2020-10-14 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


    authors: Berns JS

    更新日期:2008-05-01 00:00:00

  • Peritoneal dialysis in acute kidney injury: lessons learned and applied.

    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


    authors: Burdmann EA,Chakravarthi R

    更新日期:2011-03-01 00:00:00

  • Central vein hardware: cannot live with it, cannot live without it.

    abstract::Central vein catheters for dialysis have become an integral and unavoidable access modality for providing hemodialysis therapy despite all their major drawbacks. We report a clinical decision dilemma that every nephrologist will encounter while considering an ideal dialysis access for the steadily aging dialysis popul...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Vachharajani TJ,Moossavi S,Kaufman T,Rocco M

    更新日期:2009-09-01 00:00:00

  • Vancomycin use in patients requiring hemodialysis: a literature review.

    abstract::Vancomycin, a glycopeptide antibiotic, has remained a popular antimicrobial agent throughout the past five decades, and is often included in empiric antibiotic regimens. With gram-positive coverage, it has found a niche in the treatment of methicillin-resistant Staphylococcus aureus. Although vancomycin has been in ex...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Pallotta KE,Manley HJ

    更新日期:2008-01-01 00:00:00

  • The other side of the coin: impact of toxin generation and nutrition on the uremic syndrome.

    abstract::Both the morbidity of the uremic syndrome and the generation of uremic toxins are attributed to malnutrition. If protein intake and catabolism result in the generation of solutes, then nutritional intake should be related directly to toxicity. On the other hand, inadequate nutrition has been linked to inflammation and...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Vanholder R,Glorieux G,Lameire N

    更新日期:2002-09-01 00:00:00

  • In-center thrombolysis for clotted AV access: a cohort review.

    abstract::Thrombosis is the leading cause of arteriovenous (AV) access failure for hemodialysis patients requiring frequent interventions. We describe a novel approach to the lyse-and-wait technique in thrombosed AV access using nurse-administered thrombolytics in a hospital-based hemodialysis unit. All patients at a single-cen...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Umanath K,Morrison RS,Christopher Wilbeck J,Schulman G,Bream P,Dwyer JP

    更新日期:2013-01-01 00:00:00

  • Controversies in timing of dialysis initiation and the role of race and demographics.

    abstract::Dialysis remains the predominant form of renal replacement therapy in the United States, but the optimal timing for the initiation of dialysis remains poorly defined. Not only clinical factors such as signs/symptoms of uremia, co-existing cardiovascular disease, and presence of diabetes but also key demographic charac...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Streja E,Nicholas SB,Norris KC

    更新日期:2013-11-01 00:00:00

  • Diastolic heart failure in dialysis patients: mechanisms, diagnostic approach, and treatment.

    abstract::Heart failure (HF) is very common in the general population, and risk factors for HF, such as coronary artery disease, diabetes, obesity, and hypertension, are frequently present in patients with CKD. Therefore, HF is also an important cause of morbidity and mortality in this population. Diastolic heart failure (DHF),...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Pecoits-Filho R,Bucharles S,Barberato SH

    更新日期:2012-01-01 00:00:00

  • The catheter-challenged patient and the need to recognize the recurrently dysfunctional tunneled dialysis catheter.

    abstract::Tunneled dialysis catheters (TDC) become dysfunctional because of placement problems, infection, thrombosis, and fibrin sheath formation. Occasional patients who are catheter dependant develop frequent catheter dysfunction because of thrombosis or thrombosis associated with fibrin sheath formation. This article attemp...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Rasmussen RL

    更新日期:2010-11-01 00:00:00

  • Fatigue in chronic dialysis patients.

    abstract::Fatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, th...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Bossola M,Vulpio C,Tazza L

    更新日期:2011-09-01 00:00:00

  • Intradialytic hypotension: an overview of recent, unresolved and overlooked issues.

    abstract::The etiology and management of intradialytic hypotension has become an increasingly complex issue. Volume depletion due to ultrafiltration remains the predominant underlying etiologic factor. However, patients vary markedly in their hemodynamic tolerance to fluid removal. While many risk factors have been identified, ...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审


    authors: Sherman RA

    更新日期:2002-05-01 00:00:00

  • Incremental peritoneal dialysis: New ideas about an old approach.

    abstract::Coping with the transition from end-stage kidney disease to dialysis can be challenging for patients and their care partners. Introducing incident dialysis patients to incremental forms of dialysis is associated with better quality of life and reduced cost. Incremental hemodialysis (HD) has generated significant inter...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Auguste BL,Bargman JM

    更新日期:2018-09-01 00:00:00

  • Immunosuppressive management of dialysis patients with recently failed transplants.

    abstract::Over the past decade, patients returning to dialysis after a failed transplant comprised of 5-10% of the annual number of dialysis initiations in the United States, whereas retransplant candidates account for 5.0-13% of the annual deceased donor wait-list additions. The United States Renal Data System (USRDS) database...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Pham PT,Pham PC

    更新日期:2011-05-01 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


    authors: Putcha N,Allon M

    更新日期:2007-09-01 00:00:00

  • Experimental studies on computed tomographic peritoneography. Peritoneal and residual renal function tolerance to iodinated contrast media injected into the peritoneal cavity.

    abstract::Computed tomographic (CT) peritoneography has been widely used as reference standard to evaluate continuous ambulatory peritoneal dialysis-related complications. However, given the varying CT peritoneography approaches used across different institutions, there is no standard value for non-ionic iodinated contrast medi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Bai J,Dong J,Shu J,Xu Y,Ding W,Chen J

    更新日期:2020-03-01 00:00:00

  • Use of a covered stent in a failed forearm fistula as a present access and future bridge.

    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


    authors: Ross JL

    更新日期:2009-01-01 00:00:00

  • Use of warfarin in people with low glomerular filtration rate or on dialysis.

    abstract::Atrial fibrillation, venous thromboembolism, and access malfunction are common clinical problems in dialysis patients that prompt consideration of warfarin therapy. Atrial fibrillation appears to be more common in people with low glomerular filtration rate (GFR) or on dialysis than in the general population, but the r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Holden RM,Clase CM

    更新日期:2009-09-01 00:00:00

  • We Underdose Antibiotics in Patients on CRRT.

    abstract::Appropriate antibiotic dosing in critically ill, infected, patients receiving continuous renal replacement therapy (CRRT) is crucial to improve patient outcomes. Severe sepsis and septic shock result in changes in pharmacokinetic parameters, including increased volume of distribution, hypoalbuminemia, and changes in r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Shaw AR,Chaijamorn W,Mueller BA

    更新日期:2016-07-01 00:00:00

  • Assessing the Adequacy of Small Solute Clearance for Various Dialysis Modalities, with Inclusion of Residual Native Kidney Function.

    abstract::Measurement of small molecule clearance remains important in the clinical care of patients requiring long-term dialysis. Many patients maintain a significant degree of residual native kidney function and may have nontraditional schedules with or without combined dialysis modalities. In this review, we examine and outl...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Chin AI,Depner TA,Daugirdas JT

    更新日期:2017-05-01 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


    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

  • Peritoneal dialysis underutilization: the impact of an interventional nephrology peritoneal dialysis access program.

    abstract::Peritoneal dialysis (PD) is an underutilized form of renal replacement therapy. Recent data have emphasized that only 12% of end-stage renal disease (ESRD) patients are initiated on this form of therapy in the United States. Patients requiring PD have most often been referred to general surgeons for catheter placement...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Asif A,Byers P,Gadalean F,Roth D

    更新日期:2003-05-01 00:00:00

  • APD in the developing world: is there a future?

    abstract::Automated peritoneal dialysis (APD) has experienced significant growth in highly developed nations in the last few years, while in developing countries with important social, educational, and financial constraints this treatment modality is, at best, trying to emerge. APD offers advantages that make it popular. Some o...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Correa-Rotter R

    更新日期:2002-11-01 00:00:00

  • Coronary-subclavian steal syndrome in a hemodialysis patient, a case report and review of literature.

    abstract::Dialysis vascular access associated coronary-subclavian steal or hypoperfusion syndrome is an uncommon but potentially life threatening condition. Awareness of this syndrome is important in the management of vascular access in hemodialysis patients. We report a case of dialysis vascular access associated coronary-subc...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Tan CS,Fintelmann F,Joe J,Ganguli S,Wu S

    更新日期:2013-09-01 00:00:00

  • Convective therapies for removal of middle molecular weight uremic toxins in end-stage renal disease: a review of the evidence.

    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


    authors: Thomas G,Jaber BL

    更新日期:2009-11-01 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


    authors: Hoenich NA,Levin R,Pearce C

    更新日期:2005-09-01 00:00:00