Hemodialysis Access in the Elderly: Outcomes among Patients Older than Seventy

Jadlowiec, Caroline C.; Mannion, Elizabeth M.; Lavallee, Matthew; Brown, Matthew G.

doi:10.1016/j.avsg.2015.08.013

Cited by 12 publications

(19 citation statements)

References 17 publications

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“…When autologous arteriovenous fistula (AVF) is not possible for vascular access -necessary for haemodialysis procedures -the polytetrafluoroethylene (PTFE) arteriovenous graft is one of the most used devices [2,3]. However, until arteriovenous fistula maturation (about 3 months), the patient must continue with a haemodialysis catheter for access, which usually consists of polyurethane (PUR) material [3][4][5]. Nevertheless, in some situations where there is a delay to, failure of or clinical impediment to the AVF construction, the patient will have a catheter for a long period [3,6].…”

Section: Introductionmentioning

confidence: 99%

8-hydroxyquinoline-5-(N-4-chlorophenyl) sulfonamide and fluconazole combination as a preventive strategy for Candida biofilm in haemodialysis devices

Rocha

Pippi

Joaquim

et al. 2021

Journal of Medical Microbiology

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Introduction. The presence of Candida biofilms in medical devices is a concerning and important clinical issue for haemodialysis patients who require constant use of prosthetic fistulae and catheters. Hypothesis/Gap Statement. This prolonged use increases the risk of candidaemia due to biofilm formation. PH151 and clioquinol are 8-hydroxyquinoline derivatives that have been studied by our group and showed interesting anti-Candida activity. Aim. This study evaluated the biofilm formation capacity of Candida species on polytetrafluoroethylene (PTFE) and polyurethane (PUR) and investigated the synergistic effects between the compounds PH151 and clioquinol and fluconazole, amphotericin B and caspofungin against biofilm cells removed from those materials. Further, the synergistic combination was evaluated in terms of preventing biofilm formation on PTFE and PUR discs. Methodology. Susceptibility testing was performed for planktonic and biofilm cells using the broth microdilution method. The checkerboard method and the time–kill assay were used to evaluate the interactions between antifungal agents. Antibiofilm activity on PTFE and PUR materials was assessed to quantify the prevention of biofilm formation. Results. Candida albicans, Candida glabrata and Candida tropicalis showed ability to form biofilms on both materials. By contrast, Candida parapsilosis did not demonstrate this ability. Synergistic interaction was observed when PH151 was combined with fluconazole in 77.8 % of isolates and this treatment was shown to be concentration- and time-dependent. On the other hand, indifferent interactions were predominantly observed with the other combinations. A reduction in biofilm formation on PUR material of more than 50 % was observed when using PH151 combined with fluconazole. Conclusion. PH151 demonstrated potential as a local treatment for use in a combination therapy approach against Candida biofilm formation on haemodialysis devices.

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Section: Introductionmentioning

confidence: 99%

8-hydroxyquinoline-5-(N-4-chlorophenyl) sulfonamide and fluconazole combination as a preventive strategy for Candida biofilm in haemodialysis devices

Rocha

Pippi

Joaquim

et al. 2021

Journal of Medical Microbiology

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“…The FFBI set a goal of optimizing vascular access that prioritized AVFs over arteriovenous grafts (AVGs) and central venous catheters (7,8). Although there has been demonstrated improvement in fistula frequency since FFBI implementation, newer research reveals similar patency outcomes between AVFs and AVGs in the United States (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Supply and Distribution of Vascular Access Physicians in the United States: A Cross-Sectional Study

et al. 2020

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BackgroundBecause functioning permanent vascular access (arteriovenous fistula [AVF] or arteriovenous graft [AVG]) is crucial for optimizing patient outcomes for those on hemodialysis, the supply of physicians placing vascular access is key. We investigated whether area-level demographic and healthcare market attributes were associated with the distribution and supply of AVF/AVG access physicians in the United States.MethodsA nationwide registry of physicians placing AVFs/AVGs in 2015 was created using data from the United States Renal Data System and the American Physician Association’s Physician Masterfile. We linked the registry information to the Area Health Resource File to assess the supply of AVF/AVG access physicians and their professional attributes by hospital referral region (HRR). Bivariate analysis and Poisson regression were performed to examine the relationship between AVF/AVG access physician supply and demographic, socioeconomic, and health resource conditions of HRRs. The setting included all 50 states. The main outcome was supply of AVF/AVG access physicians, defined as the number of physicians performing AVF and/or AVG placement per 1000 prevalent patients with ESKD.ResultsThe majority of vascular access physicians were aged 45–64 (average age, 51.6), male (91%), trained in the United States (76%), and registered in a surgical specialty (74%). The supply of physicians varied substantially across HRRs. The supply was higher in HRRs with a higher percentage white population (β=0.44; SEM=0.14; P=0.002), lower unemployment rates (β=−10.74; SEM=3.41; P=0.002), and greater supply of primary care physicians (β=0.18; SEM=0.05; P=0.001) and nephrologists (β=15.89; SEM=1.22; P<0.001).ConclusionsGeographic variation was observed in the supply of vascular access physicians. Higher supply of such specialist physicians in socially and economically advantaged areas may explain disparities in vascular access and outcomes in the United States and should be the subject of further study and improvement.

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“…DeSilva et al (17) reported that there was no difference in survival among patients ages .80 years old who had an AV graft as their initial access placed predialysis compared with those with AVFs. Other studies have also found lower AVF maturation or use, greater need for interventions, and prolonged catheter dependency compared with AV grafts in the elderly (17)(18)(19)(20).…”

Section: Demographicsmentioning

confidence: 99%

New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?

Woo

2016

CJASN

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Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's ESRD life plan (hence, their overall dialysis access life plan for every vascular access creation or placement). Optimal access type and timing of access creation are also influenced by factors external to the patient, such as surgeon experience and processes of care. In this review, we will discuss the key determinants in optimal access type and timing of access creation for upper extremity arteriovenous fistulas and grafts.

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Hemodialysis Access in the Elderly: Outcomes among Patients Older than Seventy

Cited by 12 publications

References 17 publications

8-hydroxyquinoline-5-(N-4-chlorophenyl) sulfonamide and fluconazole combination as a preventive strategy for Candida biofilm in haemodialysis devices

8-hydroxyquinoline-5-(N-4-chlorophenyl) sulfonamide and fluconazole combination as a preventive strategy for Candida biofilm in haemodialysis devices

Supply and Distribution of Vascular Access Physicians in the United States: A Cross-Sectional Study

New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?

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