Thanks to technological advances like the internet and smartphones, patients and doctors have a seemingly endless stream of information at their fingertips. Patients no longer have to wait for a doctor’s phone call to get test results and can view all their information from anywhere in the world.
Behind cardiovascular disease, bloodstream infections are the second highest killer of hemodialysis patients. The death rates from infection could be halved if dialysis facilities implemented the CDC’s Core Interventions for Dialysis Bloodstream Infection Prevention, the health agency notes.
To make dialysis professionals more aware of these interventions, the Centers for Disease Control and Prevention has launched a “Making Dialysis Safer for Patients” initiative.
Chronic kidney disease (CKD), a progressive disease that can lead to kidney failure and death, affects 26 million Americans. Early detection can help to prevent or delay progression of the illness. However, early detection can be problematic because the signs and symptoms of early kidney disease are often not obvious.
The Transonic team spoke with professor Ferruh Artunc on the abstract he presented at Kidney Week 2016. Artunc’s abstract is the first study to show a prognostic significance of measuring hemodynamic parameters in HD patients. See what he had to say about it as well as the high cardiovascular death rates among hemodialysis patients below.
Clinicians from the Hospital Infanta Sofía, Madrid, Spain, undertook a three-year follow-up multicenter, prospective, open-label, controlled RCT to determine the impact of access blood flow surveillance in AV fistulas.
The group acknowledged at the outset that surveillance remains controversial because randomized RCTs failed to consistently demonstrate the benefits of flow-based surveillance even though vascular access clinical guidelines recommend monitoring and surveillance protocols to prevent vascular access thrombosis.
Pediatric nephrologists at Boston's prestigious Children's Hospital recognized that an arteriovenous (AV) access is the preferred vascular access for dialysis delivery in children and adolescents requiring chronic hemodialysis (HD). They also understood that, because of the small size of the accesses, maintenance of an access after it is created becomes all the more important and difficult.
Ultrasound dilution (UD) monitoring of AV access flow is widely used in adult HD units for early stenosis detection, but its experience in pediatrics is limited. Therefore, the Boston group they undertook a study to examine its usefulness in children and adolescents.
Carlo Basile and colleagues from hospitals in Manduria, Italy, were among the first to recognize the relationship between vascular access flow of arteriovenous fistulas (AVFs) and cardiac output (CO). In 2008 they conducted a study to glean better insight into this rarely explored aspect of HD pathophysiology.
Jennifer MacRae and her colleagues from the University of Calgary, Calgary, Alberta, Canada, reviewed the hemodynamic and cardiovascular consequences of arteriovenous fistulas. Their findings were published in a 2006 paper in Seminars in Dialysis.
MacRae identified three periods when the presence of an AV fistula influences a patient's hemodynamics.
A 1965 NBC documentary, "Who Shall Live?", narrated by Edwin Newman, created a stir. The documentary portrayed the highly controversial decision-making process that occurred during the early days of dialysis when only a few patients could be treated, and even then at great cost. The documentary showed faceless black silhouettes of the anonymous committee of community members against a stark white background as they deliberated over cases and selected which patients would receive dialysis treatment. Their decision meant life or death for the end-stage renal disease patients they were reviewing. The committee's authority was final and irrevocable. Ultimately, the serious ethical dilemma of a committee's choosing who would and wouldn't receive medical treatment to extend their lives set in motion a transformation of the healthcare system in this country.
Topics: Hospital Administration
The first hemodialysis machines at the University of Washington weighed about 1,000 pounds. They were bulky and could only treat one patient at a time. Using them cost about $10,000 annually.