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Reverse-Loop Upper Arm Arteriovenous Graft for Chronic HemodialysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, this is a logical approach for patients who have exhausted their forearm vessels for AVG creation. In addition, it also provides a platform for future creation of a secondary fistula in the upper arm. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - October 2, 2009 Category: Hematology Authors: Wen-Shin Yang, Tzu-Chun Chen, Jer-Shen Chen, Chih-Yang Chan Source Type: journals

Patency Rates for Angioplasty in the Treatment of Pacemaker-Induced Central Venous Stenosis in Hemodialysis Patients: Results of a Multi-Center StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study finds PTA to be a viable option in the management of PM/ICD lead-induced CVS. Additional studies with appropriate design and sample size are required to conclusively establish the role of PTA in the management of this problem. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - October 1, 2009 Category: Hematology Authors: Arif Asif, Loay Salman, Roger G. Carrillo, Juan D. Garisto, Gustavo Lopera, Urwa Barakat, Oliver Lenz, Alexander Yevzlin, Anil Agarwal, Florin Gadalean, Bharat Sachdeva, Tushar J. Vachharajani, Steven Wu, Ivan D. Maya, Ken Abreo Source Type: journals

Salvage of Accidentally Sectioned Peritoneal Catheter: Report of Three CasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report three cases of accidental cutting of the peritoneal catheter and present the steps taken to salvage the catheter without discontinuing the technique and avoiding withdrawal of the catheter. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - October 1, 2009 Category: Hematology Authors: Casandra Puig Hooper, Maite Rivera, Roberto Marcén, Judith Martins, Jose Luis Teruel, Carmina de la Morena, Joaquin Ortuno Source Type: journals

A Vascular Access Team Can Increase AV Fistula Creation in Pediatric ESRD Patients: A Single Center ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report outcomes of arteriovenous fistula (AVF) creation by a single surgeon in pediatric HD patients dialyzed at a single center. We further describe our experience and outcomes with the use of the operating microscope in the United States in children receiving HD under 15 kg in weight and as young as 4 years of age. AVF usage rates as well as short- and long-term patency rates can be quite high with proper management. We further illustrate that the Fistula First principles can be applied to the pediatric population in the setting of a single surgeon with single center experience. As such, we have surpassed the current ...
Source: Seminars In Dialysis - October 1, 2009 Category: Hematology Authors: Deepa H. Chand, Dale Bednarz, Matthew Eagleton, Leonard Krajewski Source Type: journals

Depression in End-Stage Renal Disease: Current Advances and ResearchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Depression or the presence of significant depressive symptoms remains common in patients with end-stage renal disease (ESRD). It is thought that 20[ndash]30% of ESRD patients have significant depressive symptoms, although there are issues surrounding the assessment of depression among patients with physical illness. Screening tools may be useful in this setting to identify patients with low affect, accompanied by formal diagnostic approaches which are important to consider following a positive screen. Recent evidence highlights the impact of depression upon mortality, and its association with non-adherence and immune param...
Source: Seminars In Dialysis - September 11, 2009 Category: Hematology Authors: Joseph Chilcot, David Wellsted, Ken Farrington Source Type: journals

Strategies for Reducing Polypharmacy and Other Medication-Related Problems in Chronic Kidney Disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Medication-related problems are very common in patients with chronic kidney disease (CKD). These problems are often avoidable and can result in detrimental patient consequences and high financial costs. Despite these risks, it is often medically necessary to prescribe multiple medications to treat the comorbid conditions that accompany CKD. In addition, patients' use of nonprescription medications and changes in pharmacokinetic and pharmacodynamic parameters may further contribute to medication-related problems in CKD, including drug interactions and the need for dosage adjustments. A structured medication ass...
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Mason NA, Bakus JL Tags: Semin Dial Source Type: journals

Depression in End-Stage Renal Disease: Current Advances and Research.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Depression or the presence of significant depressive symptoms remains common in patients with end-stage renal disease (ESRD). It is thought that 20-30% of ESRD patients have significant depressive symptoms, although there are issues surrounding the assessment of depression among patients with physical illness. Screening tools may be useful in this setting to identify patients with low affect, accompanied by formal diagnostic approaches which are important to consider following a positive screen. Recent evidence highlights the impact of depression upon mortality, and its association with non-adherence and immun...
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Chilcot J, Wellsted D, Farrington K Tags: Semin Dial Source Type: journals

An Interesting Case: Retrograde Blood Flow from a LIMA Sustaining Hemodialysis via an AVF.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract A case is described in which the inflow of a left radiocephalic arteriovenous fistula was being maintained by retrograde flow from a patent left internal mammary artery bypass graft, distal to a severe left subclavian artery stenosis. The clinical manifestations of this phenomenon were angina, lateral chest wall pain during dialysis, and distal hypoperfusion of the left hand. After stenting of the subclavian lesion, all symptoms resolved. PMID: 19747173 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Schoenkerman AB, Gimelli G, Yevzlin AS Tags: Semin Dial Source Type: journals

Arterial Interventions in Arteriovenous Access and Chronic Kidney Disease: A Role for Interventional Nephrologists.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on arterial interventions performed by interventional nephrologists and describes the epidemiology, techniques, and outcomes of arterial intervention as they relate to the care of patients with hemodialysis access and chronic kidney disease. PMID: 19747174 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Yevzlin AS, Schoenkerman AB, Gimelli G, Asif A Tags: Semin Dial Source Type: journals

Arterial Angioplasty to Treat Hand Ischemia in a Radial-Cephalic Fistula.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract A chronic hemodialysis patient was referred to interventional nephrology for evaluation of left hand pain. The patient had been receiving hemodialysis through a left radial-cephalic arteriovenous fistula and reporting hand pain during dialysis. Physical examination demonstrated cold hand and reduced capillary refill compared with the right hand. Clinical features, differential diagnosis, and physical examination findings were consistent with the diagnosis of hand ischemia due to dialysis access. Arteriography revealed >80% stenosis of the distal ulnar artery. Percutaneous balloon angioplasty successfully di...
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Samaha A, Salman L, Asif A Tags: Semin Dial Source Type: journals

Change - A New Chapter in Interventional Nephrology.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19747176 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Beathard GA Tags: Semin Dial Source Type: journals

Arterial Stent Placement in Arteriovenous Dialysis Access by Interventional Nephrologists.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This report describes arterial stent placement in patients with arteriovenous access and discusses anticoagulation considerations in such cases. PMID: 19747177 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Asif A, Yevzlin AS Tags: Semin Dial Source Type: journals

Chylothorax and Chylopericardial Tamponade in a Hemodialysis Patient with Catheter-Induced Superior Vena Cava Stenosis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the first known case of combined chylothorax and chylous pericardial tamponade in a dialysis patient associated with catheter-induced superior vena cava (SVC) stenosis. A successful outcome was achieved with drainage of both chylous effusions in combination with angioplasty of the SVC stenosis. PMID: 19747178 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Adekile A, Adegoroye A, Tedla F, Levin D, Salifu MO Tags: Semin Dial Source Type: journals

Long-Term Complication Rates and Survival of Peritoneal Dialysis Catheters: The Role of Percutaneous Versus Surgical Placement.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Considerable controversy currently exists in the literature concerning the mode of catheter placement and its impact on the technical success of peritoneal dialysis (PD). We decided to compare the impact of the surgical versus the percutaneous insertion technique on peritoneal dialysis catheter (PDCs) complications and survival. Our study population comprised 152 patients in whom 170 PDCs were inserted between January 1990 and December 2007 at the main PD unit on the island of Crete. Eighty four catheters were surgically placed (S group) and 86 were placed percutaneously by nephrologists (N group). The total e...
Source: Seminars in Dialysis - September 10, 2009 Category: Urology & Nephrology Authors: Perakis KE, Stylianou KG, Kyriazis JP, Mavroeidi VN, Katsipi IG, Vardaki EA, Petrakis IG, Stratigis S, Kroustalakis NG, Alegakis AK, Daphnis EK Tags: Semin Dial Source Type: journals

Long-Term Complication Rates and Survival of Peritoneal Dialysis Catheters: The Role of Percutaneous Versus Surgical PlacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Considerable controversy currently exists in the literature concerning the mode of catheter placement and its impact on the technical success of peritoneal dialysis (PD). We decided to compare the impact of the surgical versus the percutaneous insertion technique on peritoneal dialysis catheter (PDCs) complications and survival. Our study population comprised 152 patients in whom 170 PDCs were inserted between January 1990 and December 2007 at the main PD unit on the island of Crete. Eighty four catheters were surgically placed (S group) and 86 were placed percutaneously by nephrologists (N group). The total experience acc...
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Kostas E. Perakis, Kostas G. Stylianou, John P. Kyriazis, Vasiliki N. Mavroeidi, Irene G. Katsipi, Eleftheria A. Vardaki, Ioannis G. Petrakis, Spyros Stratigis, Nikos G. Kroustalakis, Athanasios K. Alegakis, Eugene K. Daphnis Source Type: journals

Chylothorax and Chylopericardial Tamponade in a Hemodialysis Patient with Catheter-Induced Superior Vena Cava StenosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the first known case of combined chylothorax and chylous pericardial tamponade in a dialysis patient associated with catheter-induced superior vena cava (SVC) stenosis. A successful outcome was achieved with drainage of both chylous effusions in combination with angioplasty of the SVC stenosis. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Ayoola Adekile, Adeyinka Adegoroye, Fasika Tedla, Daniel Levin, Moro O. Salifu Source Type: journals

Arterial Stent Placement in Arteriovenous Dialysis Access by Interventional NephrologistsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This report describes arterial stent placement in patients with arteriovenous access and discusses anticoagulation considerations in such cases. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Arif Asif, Alexander S. Yevzlin Source Type: journals

Change – A New Chapter in Interventional NephrologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Gerald A. Beathard Source Type: journals

Arterial Angioplasty to Treat Hand Ischemia in a Radial-Cephalic FistulaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A chronic hemodialysis patient was referred to interventional nephrology for evaluation of left hand pain. The patient had been receiving hemodialysis through a left radial-cephalic arteriovenous fistula and reporting hand pain during dialysis. Physical examination demonstrated cold hand and reduced capillary refill compared with the right hand. Clinical features, differential diagnosis, and physical examination findings were consistent with the diagnosis of hand ischemia due to dialysis access. Arteriography revealed >80% stenosis of the distal ulnar artery. Percutaneous balloon angioplasty successfully dilated the lesion...
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Antoine Samaha, Loay Salman, Arif Asif Source Type: journals

Arterial Interventions in Arteriovenous Access and Chronic Kidney Disease: A Role for Interventional NephrologistsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on arterial interventions performed by interventional nephrologists and describes the epidemiology, techniques, and outcomes of arterial intervention as they relate to the care of patients with hemodialysis access and chronic kidney disease. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Alexander S. Yevzlin, Aaron B. Schoenkerman, Giorgio Gimelli, Arif Asif Source Type: journals

An Interesting Case: Retrograde Blood Flow from a LIMA Sustaining Hemodialysis via an AVFEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A case is described in which the inflow of a left radiocephalic arteriovenous fistula was being maintained by retrograde flow from a patent left internal mammary artery bypass graft, distal to a severe left subclavian artery stenosis. The clinical manifestations of this phenomenon were angina, lateral chest wall pain during dialysis, and distal hypoperfusion of the left hand. After stenting of the subclavian lesion, all symptoms resolved. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Aaron B. Schoenkerman, Giorgio Gimelli, Alexander S. Yevzlin Source Type: journals

Strategies for Reducing Polypharmacy and Other Medication-Related Problems in Chronic Kidney DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Medication-related problems are very common in patients with chronic kidney disease (CKD). These problems are often avoidable and can result in detrimental patient consequences and high financial costs. Despite these risks, it is often medically necessary to prescribe multiple medications to treat the comorbid conditions that accompany CKD. In addition, patients' use of nonprescription medications and changes in pharmacokinetic and pharmacodynamic parameters may further contribute to medication-related problems in CKD, including drug interactions and the need for dosage adjustments. A structured medication assessment proce...
Source: Seminars In Dialysis - September 10, 2009 Category: Hematology Authors: Nancy A. Mason, Jodie L. Bakus Source Type: journals

Seeking Safe and Efficacious Anemia Management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19744148 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Coyne DW, Brennan DC Tags: Semin Dial Source Type: journals

What's Next After Fistula First: Is an Arteriovenous Graft or Central Venous Catheter Preferable When an Arteriovenous Fistula Is Not Possible?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Findings from observational studies have established that the arteriovenous fistula (AVF) is the preferred form of vascular access for chronic hemodialysis. Unfortunately, in a subset of patients with end-stage renal disease, an AVF cannot be placed or fails to mature. In these patients an alternate form of vascular access, either an arteriovenous graft (AVG) or central venous catheter (CVC) must be selected. In this review we discuss the findings and limitations of studies examining the effect of access type (AVG or CVC) on clinical endpoints including mortality, quality of life, occurrence of infections, as...
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: James MT, Manns BJ, Hemmelgarn BR, Ravani P, Tags: Semin Dial Source Type: journals

Use of Warfarin in People with Low Glomerular Filtration Rate or on Dialysis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 risk of stroke in this population is not known. No randomized trials have addressed the safety and efficacy of warfarin in these patients. Deep venous thrombosis and pulmonary embolism are also more common in this population and, again, no randomized trials have addressed the safety and efficacy of...
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Holden RM, Clase CM Tags: Semin Dial Source Type: journals

Excimer Laser Assisted Angioplasty in Hemodialysis Access Intervention.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract A case is described in which an excimer laser is used to assist angioplasty of a severe central venous lesion that is refractory to conventional techniques. Modern laser technology uses the ultraviolet (UV) spectral region to generate nanosecond pulses of energy. This results in photoablation, which is the process by which energy photons cause molecular bond disruption, while minimizing thermal damage to the surrounding vascular tissues. Further investigation of excimer laser assisted angioplasty in the setting of hemodialysis access intervention is needed to rigorously define its potential role. In occlusive ...
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Yevzlin AS, Urbanes A Tags: Semin Dial Source Type: journals

Can Chronic Volume Overload Be Recognized and Prevented in Hemodialysis Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19744152 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Twardowski ZJ Tags: Semin Dial Source Type: journals

Can Chronic Volume Overload Be Recognized and Prevented in Hemodialysis Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19744153 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Palmer BF Tags: Semin Dial Source Type: journals

Can Chronic Volume Overload Be Recognized and Prevented in Hemodialysis Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19744154 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Chazot C Tags: Semin Dial Source Type: journals

Can Chronic Volume Overload Be Recognized and Prevented in Hemodialysis Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19744155 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Sinha AD, Agarwal R Tags: Semin Dial Source Type: journals

Can Chronic Volume Overload Be Recognized and Prevented in Hemodialysis Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19744156 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 8, 2009 Category: Urology & Nephrology Authors: Locatelli F, Cavalli A, Tucci B, Viganò S, Di Filippo S Tags: Semin Dial Source Type: journals

Excimer Laser Assisted Angioplasty in Hemodialysis Access InterventionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A case is described in which an excimer laser is used to assist angioplasty of a severe central venous lesion that is refractory to conventional techniques. Modern laser technology uses the ultraviolet (UV) spectral region to generate nanosecond pulses of energy. This results in photoablation, which is the process by which energy photons cause molecular bond disruption, while minimizing thermal damage to the surrounding vascular tissues. Further investigation of excimer laser assisted angioplasty in the setting of hemodialysis access intervention is needed to rigorously define its potential role. In occlusive disease where...
Source: Seminars In Dialysis - September 8, 2009 Category: Hematology Authors: Alexander S. Yevzlin, Aris Urbanes Source Type: journals

Use of Warfarin in People with Low Glomerular Filtration Rate or on DialysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 risk of stroke in this population is not known. No randomized trials have addressed the safety and efficacy of warfarin in these patients. Deep venous thrombosis and pulmonary embolism are also more common in this population and, again, no randomized trials have addressed the safety and efficacy of warfarin in ...
Source: Seminars In Dialysis - September 8, 2009 Category: Hematology Authors: Rachel M. Holden, Catherine M. Clase Source Type: journals

What's Next After Fistula First: Is an Arteriovenous Graft or Central Venous Catheter Preferable When an Arteriovenous Fistula Is Not Possible?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Findings from observational studies have established that the arteriovenous fistula (AVF) is the preferred form of vascular access for chronic hemodialysis. Unfortunately, in a subset of patients with end-stage renal disease, an AVF cannot be placed or fails to mature. In these patients an alternate form of vascular access, either an arteriovenous graft (AVG) or central venous catheter (CVC) must be selected. In this review we discuss the findings and limitations of studies examining the effect of access type (AVG or CVC) on clinical endpoints including mortality, quality of life, occurrence of infections, as well as the i...
Source: Seminars In Dialysis - September 8, 2009 Category: Hematology Authors: Matthew T. James, Braden J. Manns, Brenda R. Hemmelgarn, Pietro Ravani Source Type: journals

Seeking Safe and Efficacious Anemia ManagementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 8, 2009 Category: Hematology Authors: Daniel W. Coyne, Daniel C. Brennan Source Type: journals

Can Chronic Volume Overload Be Recognized and Prevented in Hemodialysis Patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Seminars In Dialysis)
Source: Seminars In Dialysis - September 8, 2009 Category: Hematology Authors: Francesco Locatelli, Andrea Cavalli, Benedetta Tucci, Sara Viganò, Salvatore Di Filippo Source Type: journals

The Normal Hematocrit Cardiac Trial RevisitedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article expands and clarifies the results of the NHCT, including data that were edited from the original publication, and highlights findings from more recent studies in the field. Paradoxically, none of the randomized trials has reported an association between higher attained hemoglobin concentration and mortality within randomized groups. Mean platelet count did not increase among the patients in the normal-hematocrit group in the NHCT or in two other large trials, CREATE and CHOIR. Exposure to high doses of erythropoietic stimulating agents and/or intravenous iron could be mediating complications in the CKD anemia-...
Source: Seminars In Dialysis - July 23, 2009 Category: Hematology Authors: David A. Goodkin Source Type: journals

The Normal Hematocrit Cardiac Trial Revisited.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article expands and clarifies the results of the NHCT, including data that were edited from the original publication, and highlights findings from more recent studies in the field. Paradoxically, none of the randomized trials has reported an association between higher attained hemoglobin concentration and mortality within randomized groups. Mean platelet count did not increase among the patients in the normal-hematocrit group in the NHCT or in two other large trials, CREATE and CHOIR. Exposure to high doses of erythropoietic stimulating agents and/or intravenous iron could be mediating complications in the CKD anemia-...
Source: Seminars in Dialysis - July 22, 2009 Category: Urology & Nephrology Authors: Goodkin DA Tags: Semin Dial Source Type: journals

Evaluation of Renal Artery Stenosis in Dialysis PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Atherosclerotic renal artery stenosis (RAS), recognized as a contributor to chronic kidney disease (CKD), may be present in a substantial fraction of dialysis patients. It is generally unknown what proportion of end-stage renal disease patients on dialysis could recover kidney function if RAS were treated. Patients with CKD are often inadequately screened for RAS because of technical limitations of various screening modalities. Multiple small case series and studies have evaluated the role of revascularization for renal salvage in dialysis patients with RAS; these studies are reviewed. Large prospective, randomized multice...
Source: Seminars In Dialysis - June 25, 2009 Category: Hematology Authors: Jamie P. Dwyer, Barbara A. Greco, Julia B. Lewis Source Type: journals

Evaluation of Renal Artery Stenosis in Dialysis Patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Atherosclerotic renal artery stenosis (RAS), recognized as a contributor to chronic kidney disease (CKD), may be present in a substantial fraction of dialysis patients. It is generally unknown what proportion of end-stage renal disease patients on dialysis could recover kidney function if RAS were treated. Patients with CKD are often inadequately screened for RAS because of technical limitations of various screening modalities. Multiple small case series and studies have evaluated the role of revascularization for renal salvage in dialysis patients with RAS; these studies are reviewed. Large prospective, randomized mul...
Source: Seminars in Dialysis - June 24, 2009 Category: Urology & Nephrology Authors: Dwyer JP, Greco BA, Lewis JB Tags: Semin Dial Source Type: journals

In Good Conscience-Safely Withholding Dialysis in the Elderly.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article aims to answer these fundamental questions confronting the nephrologist in day to day clinical practice. PMID: 19558628 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - June 24, 2009 Category: Urology & Nephrology Authors: Dasgupta I, Rayner HC Tags: Semin Dial Source Type: journals

Red Blood Cell Damage from Extracorporeal Circulation in Hemodialysis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Blood damage is an unavoidable side effect of extracorporeal circulation. The effects of blood damage on patients' hematocrit and erythropoietin requirement as well as other potential side effects have not been studied for uneventful treatments. Comparing long nocturnal dialysis with regular 4-hour, three times per week dialysis allows for the conclusion that the influence of blood damage caused by extracorporeal circulation is small compared with biochemical effects. Acute hemolysis is one of the few remaining mechanical problems of dialysis. Acute hemolysis is caused by obstructions within the extracorporeal circuit ...
Source: Seminars in Dialysis - June 24, 2009 Category: Urology & Nephrology Authors: Polaschegg HD Tags: Semin Dial Source Type: journals

Red Blood Cell Damage from Extracorporeal Circulation in HemodialysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Blood damage is an unavoidable side effect of extracorporeal circulation. The effects of blood damage on patients' hematocrit and erythropoietin requirement as well as other potential side effects have not been studied for uneventful treatments. Comparing long nocturnal dialysis with regular 4-hour, three times per week dialysis allows for the conclusion that the influence of blood damage caused by extracorporeal circulation is small compared with biochemical effects. Acute hemolysis is one of the few remaining mechanical problems of dialysis. Acute hemolysis is caused by obstructions within the extracorporeal circuit caus...
Source: Seminars In Dialysis - June 24, 2009 Category: Hematology Authors: Hans-Dietrich Polaschegg Source Type: journals

In Good Conscience—Safely Withholding Dialysis in the ElderlyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article aims to answer these fundamental questions confronting the nephrologist in day to day clinical practice. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 24, 2009 Category: Hematology Authors: Indranil Dasgupta, Hugh C. Rayner Source Type: journals

Endogenous and Exogenous Vasopressin during HemodialysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Intradialytic hypotension likely results from hypovolemia as well as patient and dialysis-specific factors. An impaired vasoconstrictive response to volume loss during hemodialysis has been demonstrated and increasing evidence suggests that deficiency in the hormone arginine vasopressin may be a contributing factor. Although vasopressin is widely recognized for its role in the regulation of serum osmolality, vasopressin is also an important regulator of blood pressure in health and in various disease states. That vasopressin deficiency contributes to the pathogenesis of intradialytic hypotension is suggested by several obs...
Source: Seminars In Dialysis - June 16, 2009 Category: Hematology Authors: Aliza M. Thompson, Juan A. Oliver Source Type: journals

Thigh Grafts: A Preferable Alternative to Catheters when Upper Extremity Access Sites are ExhaustedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hemodialysis patients with failed upper extremity (arm) access sites comprise 5[ndash]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 extremity (thigh) would benefit these patients, but surgeons are often reluctant to place them, due to concerns of infection and vascular complications. As a result, these patients receive tunneled central venous catheters as their permanent dialysis access. Recent studies have shown, however, that survival and ...
Source: Seminars In Dialysis - June 11, 2009 Category: Hematology Authors: Kenneth D. Abreo, Sunanda J. Ram Source Type: journals