Abstract:
: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.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Fülöp T,Rodríguez B,Kosztaczky BA,Gharaibeh KA,Lengvárszky Z,Dossabhoy NR,Tapolyai MBdoi
10.1111/sdi.12364subject
Has Abstractpub_date
2015-09-01 00:00:00pages
E48-52issue
5eissn
0894-0959issn
1525-139Xjournal_volume
28pub_type
杂志文章abstract::Dialysis is measured as Kt/V, which scales the dose (Kt) to body water content (V). Scaling dialysis dose to body surface area (S(dub)) has been advocated, but the implications of such rescaling have not been examined. We developed a method of rescaling measured Kt/V to S(dub) and studied the effect of such alternativ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2008.00482.x
更新日期:2008-09-01 00:00:00
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
更新日期:2018-05-01 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::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
更新日期:2009-07-01 00:00:00
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
doi:10.1111/sdi.12130
更新日期:2013-11-01 00:00:00
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
更新日期:2017-11-01 00:00:00
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
更新日期:2010-01-01 00:00:00
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
更新日期:2012-05-01 00:00:00
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
doi:10.1046/j.1525-139x.2003.16051.x
更新日期:2003-05-01 00:00:00
abstract::Continuous Renal Replacement Therapy (CRRT) usually requires anticoagulation to prevent clotting of the extracorporeal circuit. Interruptions due to filter clotting significantly reduce total therapy time and CRRT efficacy. Although heparin has traditionally been the most common anticoagulant used for CRRT, increasing...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12503
更新日期:2016-07-01 00:00:00
abstract::Caring for patients with end-stage kidney disease (ESKD) in the United States is challenging, due in part to the complex epidemiology of the disease's progression as well as the ways in which care is delivered. As CKD progresses toward ESKD, the number of comorbidities increases and care involves multiple healthcare p...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12929
更新日期:2020-11-01 00:00:00
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
更新日期:2013-05-01 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::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::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::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::Concern over the inherent inefficiency of solute removal by conventional peritoneal dialysis (PD) has led to renewed interest in continuous flow PD (CFPD). We present clinical data from two experiences with CFPD. In the first, two catheters were used to recirculate a fixed intraperitoneal volume through an external ci...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1046/j.1525-139x.2001.00099.x
更新日期:2001-09-01 00:00:00
abstract::Arteriovenous grafts (AVGs) suffer from high thrombosis rates. It is not known whether placement of stent grafts at the venous anastomosis (VA) of thrombosed AVGs would impact future thrombosis. This is a retrospective study evaluating a group of AVGs that underwent endovascular thrombectomy with placement of a stent ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12254
更新日期:2014-11-01 00:00:00
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
doi:10.1111/j.1525-139X.2009.00632.x
更新日期:2009-09-01 00:00:00
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
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::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
更新日期:2014-09-01 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::Hemodialysis patients are susceptible to coronavirus disease 2019 (COVID-19). The aim of this study was to describe the epidemiological, clinical characteristics, and mortality-related risk factors for those who undergoing hemodialysis with COVID-19. We conducted a retrospective study. A total of 49 hemodialysis patie...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12928
更新日期:2020-10-29 00:00:00
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
doi:10.1111/j.1525-139X.2007.00333.x
更新日期:2008-01-01 00:00:00
abstract::Calciphylaxis, a disorder of dermal arteriolar calcification with a distinct predilection for patients with advanced kidney disease, remains an enigmatic condition that challenges clinicians. Observations regarding positive associations between levels of circulating parathyroid hormone (PTH) and the risk of calciphyla...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12502
更新日期:2016-07-01 00:00:00
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
更新日期:2015-03-01 00:00:00
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
doi:10.1111/j.1525-139X.2011.00864.x
更新日期:2011-05-01 00:00:00
abstract::Measurements of the concentration of parathyroid hormone (PTH) in serum or plasma are used widely for the initial diagnostic assessment of patients with renal bone disease, to monitor disease progression, and to gauge responses to treatment. Several analytical methods are used to measure plasma PTH levels, and a varie...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1111/j.1525-139X.2007.00230.x
更新日期:2007-01-01 00:00:00
abstract::Alternate night nocturnal hemodialysis (HD) is a popular modality in Australia. This modality grew out of a desire to increase the availability and accessibility of nocturnal HD without incurring excessive costs. It has proven popular with staff, patients, and administrators. There are limited data to support the bene...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2011.00997.x
更新日期:2011-11-01 00:00:00