Document Detail


The case for primary placement of tunneled hemodialysis catheters in acute kidney injury.
MedLine Citation:
PMID:  19944983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Nontunneled hemodialysis catheters (NTDCs) are widely used for initial hemodialysis access in new-onset renal failure. The National Kidney Foundation recommends NTDC use for hemodialysis duration of less than 1 week in acute kidney injury because of the increased infection risk compared with tunneled hemodialysis catheters (TDCs) with longer use. The present study was performed to determine whether primary placement of TDCs in this setting is more appropriate, and whether there are predictors of recovery of renal function in less than 1 week. MATERIALS AND METHODS: In the authors' practice, patients referred to the interventional radiology unit in whom no contraindications exist receive a TDC; 76 patients who received a primary TDC for acute kidney injury and who eventually recovered renal function were retrospectively reviewed herein. Causes of renal failure, various renal function parameters, and demographics were collected, as were TDC dwell times, in an effort to determine predictors of recovery and/or extended duration of use. RESULTS: Mean TDC dwell time in patients who eventually recovered from acute kidney injury was 34 days; only 15 of 76 (20%) recovered within 1 week. At TDC placement, there were no significant differences between patients who recovered in less than (vs greater than) 1 week. CONCLUSIONS: The present results support primary placement of TDCs in patients with acute kidney injury who require hemodialysis and in whom no contraindications exist, as no predictors of recovery of renal function in less than 1 week were identified.
Authors:
Lee Coryell; Jason P Lott; S William Stavropoulos; Jeffrey I Mondschein; Aalpen A Patel; Andrew Kwak; Michael C Soulen; Jeffrey A Solomon; Richard D Shlansky-Goldberg; Alexander A Nemeth; Sidney Kobrin; Michael Rudnick; Scott O Trerotola
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  20     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-30     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1578-81; quiz 1582     Citation Subset:  IM    
Affiliation:
Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Catheter-Related Infections / etiology
Catheters, Indwelling* / adverse effects
Equipment Design
Evidence-Based Medicine
Female
Humans
Kidney / injuries*,  physiopathology
Kidney Diseases / physiopathology,  therapy*
Kidney Function Tests
Male
Middle Aged
Patient Selection
Practice Guidelines as Topic
Recovery of Function
Renal Dialysis / adverse effects,  instrumentation*
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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