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Choice of dialysis access: Catheter, peritoneal, or hemodialysis 透析途径的选择：导管、腹膜或血液透析。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.09.003
Andrea Lubitz , Karen Woo
{"title":"Choice of dialysis access: Catheter, peritoneal, or hemodialysis","authors":"Andrea Lubitz ,&nbsp;Karen Woo","doi":"10.1053/j.semvascsurg.2024.09.003","DOIUrl":"10.1053/j.semvascsurg.2024.09.003","url":null,"abstract":"<div><div>The most recent National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines shifted emphasis to kidney replacement modality selection and vascular access planning and creation of the Endstage Kidney Disease Life-Plan, which promotes a patient-centered approach. The Life-Plan is intended to be created through discussions between the patient and their multidisciplinary care team to ultimately develop a lifelong kidney replacement therapy strategy. The focus of the Life-Plan is to engage the patient in a multidisciplinary patient-centered approach. The Life-Plan includes selection of the most suitable treatment modality (eg, hemodialysis, peritoneal dialysis, or transplantation), setting (home or center), and type of vascular access. Ultimately, this approach considers overall patient health, preferences, and anatomic factors. Patients choose between hemodialysis, which can be performed either in center or at home, and peritoneal dialysis. When considering vascular access, options consist of tunneled dialysis catheter, arteriovenous fistula, and arteriovenous graft. Each modality and vascular access type has benefits and disadvantages that should be weighed carefully with the patient and their supportive team to arrive at a decision that aligns as closely as possible with each individual patient's circumstances.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 369-374"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effects of hemodialysis on the cardiovascular system 血液透析对心血管系统的影响。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.001
Zachary S. Pallister, Jayer Chung
{"title":"The effects of hemodialysis on the cardiovascular system","authors":"Zachary S. Pallister,&nbsp;Jayer Chung","doi":"10.1053/j.semvascsurg.2024.10.001","DOIUrl":"10.1053/j.semvascsurg.2024.10.001","url":null,"abstract":"<div><div>Chronic kidney disease and dialysis-dependent end-stage renal disease are increasing in prevalence in the United States. The costs associated with end-stage renal disease management comprise approximately 1% of the federal government's annual budget. Chronic kidney disease and end-stage renal disease cause significant derangements of the cardiac and vascular system. Pathophysiologic hallmarks include alterations of the renin–angiotensin system, chronically increased sympathetic tone, calcium and phosphate imbalance, pro-inflammatory cytokine release, and uremic toxin accumulation. This results in several pathologies specific to the cardiac and vascular systems, which will each be reviewed separately herein.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 419-426"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tunneled dialysis catheter: Simple, re-do, complicated 隧道式透析导管：简单、重做、复杂
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.009
Ehab Sorial , Mrinal Shukla
{"title":"Tunneled dialysis catheter: Simple, re-do, complicated","authors":"Ehab Sorial ,&nbsp;Mrinal Shukla","doi":"10.1053/j.semvascsurg.2024.10.009","DOIUrl":"10.1053/j.semvascsurg.2024.10.009","url":null,"abstract":"<div><div>Tunneled dialysis catheter (TDC) placement plays an essential role in hemodialysis patients. These catheters are inserted in a significant number of patients prior to establishing permanent dialysis access. Insertion is often simple and straightforward, and the preference is to use the right internal jugular vein due to fewer chances of long-term complications. However, significant obstacles exist including upper body central venous occlusions making catheter insertion complicated. In this report, we describe the technique of TDC insertion in the upper body, known complications from long-term TDC insertion, upper body central venous occlusion as an obstacle for TDC placement as well as the solutions available to mitigate this problem. Additionally, we will review techniques to convert TDC into long-term hemodialysis access.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 358-363"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of carotid disease in the end-stage renal disease patient 终末期肾病患者的颈动脉疾病管理。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.09.002
Ali AbuRahma, Zachary AbuRahma
{"title":"Management of carotid disease in the end-stage renal disease patient","authors":"Ali AbuRahma,&nbsp;Zachary AbuRahma","doi":"10.1053/j.semvascsurg.2024.09.002","DOIUrl":"10.1053/j.semvascsurg.2024.09.002","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) has been increasing in incidence as a result of the growing prevalence of diabetes and other risk factors for cardiovascular disease. This study highlights reports related to management of carotid disease in patients with CKD, with a special emphasis on end-stage renal disease (ESRD). Several earlier studies found that patients with CKD are more likely to die from cardiovascular causes than progress to ESRD requiring dialysis. Data derived from the US Renal Data System showed that the 30-day stroke/death rate was 10% after carotid endarterectomy and 11% after carotid artery stenting in patients on dialysis, with a median postoperative survival of 2.5 years. However, these data were representative of a patient cohort from 2005 to 2008. In the past 2 decades, significant life expectancy gains have been noted for patients with ESRD. Recent studies reported adjusted mortality has decreased by 20% in patients on hemodialysis and 29% in patients who underwent transplantation. In addition, recent studies have found that among patients with CKD, carotid endarterectomy and transcarotid artery revascularization had stroke/death rates of &lt;2% for asymptomatic patients and &lt;3% for symptomatic patients. Based on studies published to date, the risk of carotid intervention, whether carotid endarterectomy or stenting, specifically transcarotid artery revascularization, can be justified for carefully selected symptomatic patients with severe CKD with acceptable operative risk and good long-term life expectancy. However, patients with asymptomatic carotid disease and severe CKD, specifically ESRD, should be offered best optimal medical therapy unless life expectancy exceeds what has been recommended by recent Society for Vascular Surgery carotid guidelines.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 427-432"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of thrombosed or failed dialysis access 处理血栓形成或失效的透析通路。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.006
Stephen N. Dalton-Petillo, Jeffrey J. Siracuse
{"title":"Management of thrombosed or failed dialysis access","authors":"Stephen N. Dalton-Petillo,&nbsp;Jeffrey J. Siracuse","doi":"10.1053/j.semvascsurg.2024.10.006","DOIUrl":"10.1053/j.semvascsurg.2024.10.006","url":null,"abstract":"<div><div>Hemodialysis (HD) access for patients with end-stage renal disease is a steadily increasing necessity, and maintaining patency of native or synthetic fistulas can be challenging. The main physiologic changes of an HD access that cause it to fail are inflow or outflow vessel stenosis or access thrombosis. These are propagated by factors intrinsic to end-stage renal disease, altered hemodynamics from a fistula, and typically further exacerbated by associated comorbidities. Diagnosis of fistula dysfunction can be made with a combination of history, physical examination, HD dynamic measurements, laboratory findings, and invasive or noninvasive imaging. Stenoses can be managed with endovascular interventions, including angioplasty with or without stenting, or open operations. Thrombosis of HD access, which is most often a result of an underlying stenosis, can be managed similarly with either endovascular or surgical thrombectomy with adjunctive treatment. Our goal was to review the pathophysiology of the most common forms of fistula failure, diagnosis, and endovascular and surgical options for flow restoration.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 394-399"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Review of maintenance and surveillance of dialysis access 透析途径维持和监测的审查。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.008
Shayna Brathwaite , Amber B. Kernodle , Nader N. Massarweh , Olamide Alabi
{"title":"Review of maintenance and surveillance of dialysis access","authors":"Shayna Brathwaite ,&nbsp;Amber B. Kernodle ,&nbsp;Nader N. Massarweh ,&nbsp;Olamide Alabi","doi":"10.1053/j.semvascsurg.2024.10.008","DOIUrl":"10.1053/j.semvascsurg.2024.10.008","url":null,"abstract":"<div><div>Vascular access is an essential component of the Patient Life-Plan, Access Needs for patients with end-stage kidney disease requiring kidney replacement therapy with hemodialysis. Central venous catheter use is associated with high morbidity and mortality. As such, arteriovenous access (AVA) is the preferred modality for hemodialysis. Although AVA is preferred, maturation and functional patency after creation can be a challenge to achieve. A significant proportion of AVAs fail to mature, require reinterventions to achieve maturation, or cannot be successfully cannulated and used reliably for hemodialysis, despite physiologic maturation. Thus, most patients on hemodialysis require multiple AVA procedures throughout their lifetime. A thoughtful and deliberate strategy to create, maintain, survey, and troubleshoot AVA is required. In this review, autogenous AVA maturation, maintenance, and surveillance strategies to prolong the life of AVA for patients requiring hemodialysis are discussed.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 387-393"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of dialysis on peripheral arterial disease 透析对外周动脉疾病的影响。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.09.001
Sean C. Liebscher, Daniel J. Bertges
{"title":"Effects of dialysis on peripheral arterial disease","authors":"Sean C. Liebscher,&nbsp;Daniel J. Bertges","doi":"10.1053/j.semvascsurg.2024.09.001","DOIUrl":"10.1053/j.semvascsurg.2024.09.001","url":null,"abstract":"<div><div>End-stage renal disease is an independent risk factor for the development of peripheral arterial disease, with considerably worse outcomes in patients with concomitant diseases. It is important to realize the widespread, yet frequently asymptomatic, nature of peripheral arterial disease in patients with end-stage renal disease due to the presence of other comorbidities that decrease activity levels and sensation to allow for early recognition and timely medical management to try and mitigate otherwise poor outcomes. Despite their high risk, properly selected patients derive benefit from revascularization; both open and endovascular approaches provide similar outcomes in terms of overall survival, amputation-free survival, and limb salvage, with perhaps a slight preference toward open repair. This narrative review of the literature evaluates the epidemiology, pathophysiology, outcomes, and management strategies that provide the best possible outcomes for patients with peripheral arterial disease and end-stage renal disease.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 412-418"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of dialysis access in the post-transplantation patient 移植后患者透析通路的管理。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.005
Lindsay Lynch, Kevin Chang, Ashlee Stutsrim, Maureen Sheehan, Matthew Edwards
{"title":"Management of dialysis access in the post-transplantation patient","authors":"Lindsay Lynch,&nbsp;Kevin Chang,&nbsp;Ashlee Stutsrim,&nbsp;Maureen Sheehan,&nbsp;Matthew Edwards","doi":"10.1053/j.semvascsurg.2024.10.005","DOIUrl":"10.1053/j.semvascsurg.2024.10.005","url":null,"abstract":"<div><div>Arteriovenous fistula (AVF) is the preferred access for hemodialysis in patients with end-stage renal disease, and arteriovenous grafts are used when AVF creation is not feasible. Post renal transplantation, hemodialysis may be needed due to delayed graft function or transplantation failure. This review aimed to summarize current evidence on the impact of maintaining versus ligating AV access on renal function and cardiovascular outcomes post transplantation. A comprehensive review of literature was conducted, analyzing studies on the effects of AVF and AV graft maintenance or ligation on renal and cardiovascular outcomes in patients post transplantation. Evidence indicates that maintaining AVF post transplantation is associated with higher estimated glomerular filtration rate and better renal function retention, but poses risks for cardiovascular complications, such as left ventricular hypertrophy. Ligation of AVF is linked to improved cardiovascular outcomes, including reduced N-terminal pro-B-type natriuretic peptide levels, but may lead to a greater decline in estimated glomerular filtration rate. No significant difference in long-term renal allograft survival was observed between maintaining and ligating AV access. The decision to maintain or ligate AV access in patients post renal transplantation should be individualized, considering both renal function preservation and cardiovascular health. Although maintaining AVF may benefit renal function, it poses cardiovascular risks, whereas ligation can mitigate these risks without significantly affecting allograft survival.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 407-411"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peritoneal dialysis catheter insertion and maintenance 腹膜透析导管的插入和维护。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.002
James J. Wynn
{"title":"Peritoneal dialysis catheter insertion and maintenance","authors":"James J. Wynn","doi":"10.1053/j.semvascsurg.2024.10.002","DOIUrl":"10.1053/j.semvascsurg.2024.10.002","url":null,"abstract":"<div><div>The treatment of end-stage kidney disease (ESKD with peritoneal dialysis (PD) continues to increase. Timely initiation of PD is dependent on successful PD catheter placement, which can be performed using open or laparoscopic surgical or percutaneous techniques. Dialysis access surgeons who incorporate PD catheter insertion in their practice can uniquely offer comprehensive access services to their patients. This review discusses the various methods of PD catheter insertion, patient conditions that impact surgical decision-making, and the management of catheter-related complications.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 375-386"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alternatives for exhausted dialysis access 用尽透析通道的替代方案。
IF 3.3 3区 医学
Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.003
Laura B. Pride, Edwyn J. Assaf, Lauren N. West-Livingston, Christina L. Cui, Tristen T. Chun, Chandler A. Long
{"title":"Alternatives for exhausted dialysis access","authors":"Laura B. Pride,&nbsp;Edwyn J. Assaf,&nbsp;Lauren N. West-Livingston,&nbsp;Christina L. Cui,&nbsp;Tristen T. Chun,&nbsp;Chandler A. Long","doi":"10.1053/j.semvascsurg.2024.10.003","DOIUrl":"10.1053/j.semvascsurg.2024.10.003","url":null,"abstract":"<div><div>Hemodialysis (HD) access failure is a frequent problem encountered by vascular surgeons. As treatment of end-stage renal disease improves and patients live longer on HD, eventual exhaustion of traditional upper extremity HD access is common. Efforts to preserve and maintain these accesses are essential. However, when they fail, alternative surgical access options should be pursued prior to destination-tunneled dialysis catheters. Hemodialysis Reliable Outflow grafts as well as various configurations of lower extremity arteriovenous fistulae and grafts can be utilized. For most alternative HD access options, there is a paucity of data for long-term patency, cost, and risk of infectious or ischemic complications compared to traditional options. However, smaller studies examining Hemodialysis Reliable Outflow grafts, femoral vein transposition, and lower extremity grafts show acceptable safety and efficacy. Depending on the cause of traditional access failure and patient-specific anatomic constraints, we recommend a systematic approach to alternative access creation, with destination-tunneled dialysis catheters reserved as a last resort. The most common cause of HD access failure is venous outflow obstruction. As such, we have structured this manuscript around a meta-analysis of retrospective studies describing nontraditional access options that can be utilized with escalating degrees of central venous stenosis or occlusion.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 400-406"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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