Abstract:
:One hundred twenty-eight hemodialysis patients and 64 medical personnel consisting of dialysis nurses and technicians, hemodialysis access surgeons and nephrologists were surveyed about their preferences and concerns in regard to the hemodialysis vascular access. The access preferred by physicians was the A-V fistula in the lower arm. In contrast, the access preferred by dialysis nurses and technicians was the polytetrafluoroethylene (PTFE) graft in the lower arm. Patients desired a superficial access in the forearm which was easy to cannulate, had minimal effect on their appearance, provided quick hemostasis after dialysis and enabled arm comfort during dialysis. Physicians felt the most significant concerns about the access were thrombosis and infection. Nurses and technicians ranked difficult cannulation and insufficient access blood flows that prohibited dialysis adequacy as their major problems. For patients the most common problem was pain during needle insertion. This survey concluded that the A-V fistula remains the access of choice. However, appropriate maturation of the fistula must occur before needle insertion is attempted. An immature fistula is difficult to cannulate, has fragile veins resulting in blood leakage around the needle infiltrating the subcutaneous tissues and has inadequate blood flows for successful dialysis. Patients who are introduced to dialysis with inadequate access function or access failure from either an A-V fistula or a PTFE graft have increased morbidity, inadequate dialysis and enhanced anxiety about dialysis treatments. To increase the success and acceptance of A-V fistulas in hemodialysis patients it is incumbent upon the nephrologist to protect the future access arm from damage to the vasculature and to allow for fistula maturation before cannulation. Surgical protocols must improve the appropriate selection of a fistula or PTFE graft for various age groups and disease categories. Better patient preparation and selection of the proper access type for each patient will enhance early access function and subsequent access survival.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Bay WH,Van Cleef S,Owens Mdoi
10.1159/000013380subject
Has Abstractpub_date
1998-01-01 00:00:00pages
379-83issue
5eissn
0250-8095issn
1421-9670pii
13380journal_volume
18pub_type
杂志文章abstract:BACKGROUND:Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play an important role in the atherosclerosis. Recombinant human erythropoietin (EPO) has become widely used to treat anemic hemodialyzed (HD) patients; however, an increased mortality has been reported for HD patients with cardiovascular d...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000101191
更新日期:2007-01-01 00:00:00
abstract::Hemolytic-uremic syndrome following quinine ingestion is a newly described phenomenon, with just two previous descriptions of 4 cases in the literature. We describe a 5th case. The reaction may be mediated by the presence of antibodies reactive against platelets in the presence of quinine. Treatment has included use o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168444
更新日期:1992-01-01 00:00:00
abstract::Bicarbonate dialysate is claimed to be superior to acetate for both chronic and acute hemodialysis. We compared acetate and bicarbonate dialysates in 30 acute renal failure patients during 120 dialyses. 4 patients were diabetic and 2 had liver failure. Patients were dialyzed alternating acetate and bicarbonate dialysa...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000166484
更新日期:1981-01-01 00:00:00
abstract::We studied plasma, dialysate, and muscle carnitine levels in patients with stable chronic renal failure on hemodialysis, and intermittent peritoneal, or continuous ambulatory peritoneal dialysis (CAPD). In patients on hemodialysis, plasma carnitine levels fell from 46.2 +/- 4.5 mumol/l (mean +/- SEM) to 18.8 +/- 2.7 m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166711
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:We determined the familial aggregation of end-stage renal disease (ESRD) in a large, population-based sample of incident ESRD cases to assess the feasibility of developing a targeted screening and prevention program directed at members of families at high risk for kidney disease. METHODS:Between January 1, ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000088491
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Vitamin D deficiency, sympathetic activation and endothelial dysfunction are associated with increased cardiovascular risk in patients with chronic kidney disease (CKD). Studies have so far failed to establish the role of vitamin D and vitamin D receptor activator (VDRA) treatment in moderate CKD. This trial...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000441364
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Three million people in the United States are estimated to have chronic kidney disease (CKD). Management of these CKD patients in the outpatient primary care clinic setting has not been well studied. HYPOTHESIS:Primary care management of CKD can be assessed and opportunities for improvement can be identifie...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000066296
更新日期:2003-01-01 00:00:00
abstract::The development of new therapies for chronic diseases, such as diabetic kidney disease (DKD), will continue to be hampered by lack of sufficient biomarkers that will provide insights and will be responsive to treatment interventions. The recent application of metabolomic technologies, such as nuclear magnetic resonanc...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000447954
更新日期:2016-01-01 00:00:00
abstract::Extraskeletal tumoral calcinosis occur in uremic patients with high calcium phosphorus (Ca x P) product and progressive secondary hyperparathyroidism. However, cases are also described in which this association cannot be confirmed. The influence of aluminum, vitamins D and K, alkalosis, magnesium and local lesions is ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000169078
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND/AIMS:Living donor nephrectomy can be associated with increases in blood pressure several years following the procedure, but the best method to assess blood pressure during the living donor evaluation process is unclear. METHODS:Living kidney donors underwent casual clinic and ambulatory blood pressure monit...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000335070
更新日期:2012-01-01 00:00:00
abstract::Skin ulceration is a well-characterized thrombotic complication of the heparin-induced thrombocytopenia (HIT) syndrome. We present the case of a 73-year-old diabetic woman nearing end-stage renal failure who developed extensive upper thigh, abdominal and buttock ulceration following initiation of subcutaneous heparin ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046263
更新日期:2001-07-01 00:00:00
abstract::Bacterial endocarditis, particularly involving the left side, has been shown to occur in patients in regular hemodialysis. We report a case of right-sided endocarditis characterized by a very torpid evolution. Although the diagnosis was suspected early in the course, confirmation was obtained 2 months after the onset....
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168806
更新日期:1995-01-01 00:00:00
abstract::John Bostock has a reasonable claim to being one of the first chemical pathologists. Most of his work was done before that of William Prout, with whom both he and Bright were in contact. Bostock's work was done about the same time as that of his friends and colleagues Marcet and Wollaston. Although other, notably Crui...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000168749
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:There is continued and significant debate regarding the salient etiologies associated with graft loss and racial disparities in kidney transplant recipients. METHODS:This was a longitudinal cohort study of all adult kidney transplant recipients, comparing patients with early graft loss (<5 years) to those w...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000363393
更新日期:2014-01-01 00:00:00
abstract::To elucidate the prevalence and clinical implications of antineutrophil cytoplasmic antibody (ANCA) in lupus nephritis (LN), we examined ANCA by indirect immunofluorescence and by ELISA against antilactoferrin (anti-LF) and antimyeloperoxidase (anti-MPO) antibody. To discriminate perinuclear ANCA (pANCA) with antinucl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013557
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIMS:Cisplatin (CIS) induces nephrotoxicity partly through renal vasoconstriction and decreased glomerular filtration effects thought to involve adenosine acting on adenosine A(1) receptors (A1Rs). We studied the effect of the orally active, A1R antagonist tonapofylline (BG9928) on biochemical measures of re...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000248762
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a prevalent condition; however, little is known about healthcare resource utilization (HRU) by CKD patients. METHODS:This analysis included NHANES participants aged > or =18 years, with serum creatinine, urine protein, and hemoglobin measurements. We assessed the association ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000178816
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIMS:The elderly are the fastest growing subpopulation with end-stage renal disease. The goal of our study was to define characteristics of elderly patients who were considered ineligible for transplantation compared to those who were listed. METHODS:984 patients were referred for evaluation during a 2-year...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000354483
更新日期:2013-01-01 00:00:00
abstract::The relationship between abnormalities in nocturnal penile tumescence (NPT) and autonomic function, measured by the Valsalva maneuver, was evaluated in 25 uremic patients and 22 normal subjects. NPT in uremic patients (45 +/- 6.8 min/night) was lower (p less than 0.01) than in normals (85 +/- 10.4 min/night). Valsalva...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166629
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the effect of exercise on health is well established, nephrologists seldom consider physical activity in the treatment of chronic kidney disease (CKD) or CKD in the presence of diabetes mellitus (DM/CKD). The aim of the present study was to analyze the benefits of leisure-time physical activity...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000357133
更新日期:2013-01-01 00:00:00
abstract::The pathogenesis of calciphylaxis, a potentially life-threatening condition, is not well understood. Several factors such as end-stage renal disease (azotemia), hyperparathyroidism, hyperphosphatemia, hypercalcemia, a high calcium-phosphate product, and the use of steroids and cytotoxic drugs after kidney transplantat...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169021
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Health-related quality of life (HRQOL) reflects a patient's perceived disease burden, treatment effectiveness, and health status. Given the time burden and physiologic effects of hemodialysis, patients who spend dialysis time (9-15 h/week) physically or intellectually engaged may have better HRQOL. We charac...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000492623
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:The susceptibility of patients on maintenance hemodialysis (MHD) to infections is a major cause of mortality and morbidity. Natural resistance-associated macrophage protein 1 (Nramp1) regulates intracellular pathogen proliferation, and its mRNA expression is highest in polymorphonuclear leukocytes (PMNL...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000337742
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:While the etiology of idiopathic nephrotic syndrome (idiopathic nephrotic syndrome [INS]; characterized by repeated relapses and comorbid allergic conditions) remains unknown, recent evidence suggests that dysfunction in regulatory T cells (Tregs) plays an important role in the development of INS as well as ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487557
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:Few published data describe survival rates for pediatric end-stage renal disease (ESRD) patients. We aimed to describe one-year mortality rates for US pediatric ESRD patients over a 15-year period. METHODS:In this retrospective cohort study, we used the US Renal Data System database to identify period-...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000380828
更新日期:2015-01-01 00:00:00
abstract::Hepcidin is a key regulator of iron metabolism. In this study, we examined whether measurement of hepcidin is useful in assessing recombinant human erythropoietin (rHuEPO) responsiveness in regular hemodialysis (HD) patients in a cross-sectional fashion. We examined the association between serum prohepcidin, a prohorm...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000109968
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is evidence that hereditary predisposition contributes to the development of diabetic nephropathy and hypertension. Polymorphisms in the genes for bradykinin receptors (B(1)R and B(2)R) were found to be associated with decreased risk of the development of end-stage renal disease. This study examin...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000068035
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND/AIMS:Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare renal tubular disorder complicated by progressive renal failure during childhood or adolescence. Recently, causative mutations in the CLDN19 gene have been identified in FHHNC patients presenting with severe ocular involv...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330854
更新日期:2011-01-01 00:00:00
abstract::This study was carried out to find out whether Ramadan fasting would affect the renal function in kidney transplant recipients with normal or impaired graft function. Twenty-three transplant recipients, 17 with a normal function and 6 with an impaired but stable function with plasma creatinine levels not exceeding 300...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013316
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Steroid therapy has become an effective option for patients with primary Sjogren's syndrome with tubulointerstitial nephritis (TIN), while the use of cytotoxic agents is still debated. Our study aimed to compare the clinical outcomes of patients treated with cyclophosphamide (CTX) combined with glucocorticoi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000484903
更新日期:2017-01-01 00:00:00