WoundClot® Hemostatic Gauze Reduces Bleeding Time after Arterial Venous Fistula Decannulation

2021 ◽  
pp. 1-7
Author(s):  
Orit Kliuk-Ben Bassat ◽  
Doron Schwartz ◽  
Alexander Zubkov ◽  
Amir Gal-Oz ◽  
Alexander Gorevoy ◽  
...  
Keyword(s):  
Bleeding Time ◽  
Control Group ◽  
Dialysis Adequacy ◽  
Cotton Gauze ◽  
Single Center Study ◽  
Time Required ◽  
Venous Fistula ◽  
Thrombosis Rate

<b><i>Introduction:</i></b> Decannulation of the arteriovenous fistula (AVF) after each hemodialysis session requires a precise compression on the needle puncture site. The objective of our study was to evaluate the bleeding time (BT) needed to achieve hemostasis using WoundClot, an innovative hemostatic gauze, and to assess whether its long-term use can improve AVF preservation. <b><i>Methods:</i></b> This is a prospective single center study. Initially, the time to hemostasis after AVF decannulation was compared between WoundClot and cotton gauze in 24 prevalent hemodialysis patients. Thereafter, the patients continued to use WoundClot for 12 months and were compared to a control group consisting of 25 patients using regular cotton gauze. Follow-up data included parameters of dialysis adequacy, AVF interventions, and thrombotic events. <b><i>Results:</i></b> WoundClot use shortened significantly the time needed for hemostasis. Mean venous BT decreased by 3.99 (±4.6) min and mean arterial BT by 6.38 (±4.8) min when using WoundClot compared to cotton gauze (<i>p</i> &#x3c; 0.001). At the end of the study, dialysis adequacy expressed by spKt/V was higher in the WoundClot group compared to control (1.73 vs. 1.53, respectively, <i>p</i> = 0.047). Although patients in WoundClot group had a higher baseline BT, arterial and venous pressures did not differ between the groups after a median follow up of 10.8 months. AVF thrombosis rate was similar between the groups. <b><i>Conclusions:</i></b> WoundClot hemostatic gauze significantly reduced the time required for hemostasis after AVF decannulation and may be associated with better AVF preservation. We suggest using WoundClot for arterial BT longer than 15 min and for venous BT longer than 12.5 min.

Predialytic versus Intradialytic Nutrition: A Study to Assess Effects on Intradialytic Blood Pressure, Dialysis Adequacy, and Urea Removal

2021 ◽  
pp. 1-6
Author(s):  
Namrata S. Rao ◽  
Abhilash Chandra ◽  
Sai Saran ◽  
Manish Raj Kulshreshta ◽  
Prabhakar Mishra ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Dialysis Adequacy ◽  
Fasting Period ◽  
Significant Group ◽  
Protein Requirements ◽  
Dialysis Vintage ◽  
Oral Nutritional Supplements ◽  
Blood Pressures ◽  
Group 2 ◽  
Group 1

<b><i>Background:</i></b> Provision of oral protein in hemodialysis (HD) is desirable due to improved compliance to protein requirements and better nutritional status, but the risks of hypotension and underdialysis need to be considered. This study compared 2 different timings for administering oral nutritional supplements (ONS), predialysis and mid-dialysis, with respect to hemodynamics, dialysis adequacy, urea removal, and tolerability. <b><i>Methods:</i></b> This single-center, prospective crossover study analyzed 72 stable patients with ESRD on twice a week maintenance HD with a mean age of 38.7 (±11.2) years and a dialysis vintage of 28.2 (±13.1) months. In the first week, all the patients received ONS (450 kcal energy, 20 g protein) 1 h prior to start of dialysis (group 1) and in the next week, the supplement was administered after 2 h of start of dialysis (group 2), with a predialysis fasting period of at least 3 h in both groups. Blood pressures, serum, and spent dialysate samples were collected and nausea occurrence was noted by severity. <b><i>Results:</i></b> Predialytic intake (group 1) was associated with higher predialysis and 1st hour blood urea, dialysis adequacy, and urea removal than group 2. Both groups achieved mean Kt/V &#x3e; 1.2, and the occurrence of symptomatic hypotensive episodes and nausea was not significantly different between the groups. On repeated measures ANOVA, changes in blood urea over time showed significant group effect. <b><i>Conclusions:</i></b> Predialytic supplementation was associated with better dialysis adequacy and urea removal than intradialytic supplementation. However, both timings were equally tolerated and not associated with underdialysis.

scholarly journals Hemodialysis (HD) dose and ultrafiltration rate are associated with survival in pediatric and adolescent patients on chronic HD—a large observational study with follow-up to young adult age

2021 ◽  
Author(s):  
Verena Gotta ◽  
Olivera Marsenic ◽  
Andrew Atkinson ◽  
Marc Pfister
Keyword(s):  
Rank Test ◽  
Primary Analysis ◽  
Ultrafiltration Rate ◽  
Dialysis Dose ◽  
Dialysis Adequacy ◽  
Weibull Regression ◽  
Adult Age ◽  
Kaplan Meier ◽  
Continuous Scale ◽  
Weibull Regression Model

Abstract Background Hemodialysis (HD) dose targets and ultrafiltration rate (UFR) limits for pediatric patients on chronic HD are not known and are derived from adults (spKt/V>1.4 and <13 ml/kg/h). We aimed to characterize how delivered HD dose and UFR are associated with survival in a large cohort of patients who started HD in childhood. Methods Retrospective analysis on a cohort of patients <30 years, on chronic HD since childhood (<19 years), having received thrice-weekly HD 2004–2016 in outpatient DaVita centers. Outcome: Survival while remaining on HD. Predictors: (I) primary analysis: mean delivered dialysis dose stratified as spKt/V ≤1.4/1.4–1.6/>1.6 (Kaplan–Meier analysis), (II) secondary analyses: UFR and alternative dialysis adequacy measures [eKt/V, body-surface normalized Kt/BSA] on continuous scale (Weibull regression model). Results A total of 1780 patients were included (age at the start of HD: 0–12y: n=321, >12–18y: n=1459; median spKt/V=1.55, eKt/V=1.31, Kt/BSA=31.2 L/m2, UFR=10.6 mL/kg/h). (I) spKt/V<1.4 was associated with lower survival compared to spKt/V>1.4–1.6 (P<0.001, log-rank test), and spKt/V>1.6 (P<0.001), with 10-year survival of 69.3% (59.4–80.9%) versus 83.0% (76.8–89.8%) and 84.0% (79.6–88.5%), respectively. (II) Kt/BSA was a better predictor of survival than spKt/V or eKt/V. UFR was additionally associated with survival (P<0.001), with increased mortality <10/>18 mL/kg/h. Associations did not alter significantly following adjustment for demographic characteristics (age, etiology of kidney disease, and ethnicity). Conclusions Our results suggest usefulness of targeting Kt/BSA>30 L/m2 for best long-term outcomes, corresponding to spKt/V>1.4 (>12 years) and >1.6 (<12 years). In contrast to adults, higher UFR of 10–18 ml/kg/h was not associated with greater mortality in this population.

scholarly journals Assessing dialysis adequacy and dietary intake in the individual hemodialysis patient

1999 ◽  
Vol 55 (5) ◽  
pp. 1961-1969 ◽  
Author(s):  
Wybe D. Kloppenburg ◽  
Coen A. Stegeman ◽  
Marieke Hooyschuur ◽  
José van der Ven ◽  
Paul E. de Jong ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Hemodialysis Patient ◽  
Dialysis Adequacy ◽  
The Individual

scholarly journals Hemodialysis Experience of a Large Group of Syrian Refugees in Turkey: All Patients Deserve Effective Treatment

2019 ◽  
Vol 44 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Meltem Gursu ◽  
Mustafa Arici ◽  
Kenan Ates ◽  
Rumeyza Kazancioglu ◽  
Pinar Guneser Yavas ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Maintenance Hemodialysis ◽  
Syrian Refugees ◽  
Dialysis Adequacy ◽  
Limited Experience ◽  
Dialysis Vintage ◽  
One Year ◽  
Age Range ◽  
Annual Mortality

Background/Aims: Refugee dialysis is a worldwide growing dilemma with limited experience. This report presents the largest hemodialysis (HD) patient registry data of Syrian refugees in Turkey. Methods: Demographic, clinical, laboratory, and dialysis practice data of 345 Syrian HD patients during one year were collected and analyzed. Results: There were 345 prevalent Syrian HD patients at the end of 2016. Majority of the patients were placed in the Southeast Anatolian Region. The majority of the patients (74.8%) are in the age range of 20-64 years. Dialysis vintage in Turkey is less than 12 months in 20.8% and less than one month in 29.3% of patients. The vascular access was arteriovenous fistula in the majority of patients (72.5%). Kt/V is over 1.7 in 57%, serum albumin is above 35 g/L in 65.8% and hemoglobin level is more than 100 g/L in %65.2 of the patients. The ratio of patients with serum phosphorus level of 1.13-1.77 mmol/L was 56.2%. Twenty Syrian HD patients (14 male, 6 female) died within the year 2016 and annual mortality rate was 5.7%. Conclusion: This study with the largest number of Syrian refugees undergoing maintenance hemodialysis showed good dialysis practices, acceptable values for dialysis adequacy and biochemical parameters along with lower mortality compared to native HD population of Turkey. Longer follow up will enrich the knowledge related to care of refugee population in all over the world.

scholarly journals Impact of gender and dialysis adequacy on anaemia in peritoneal dialysis

2017 ◽  
Vol 49 (5) ◽  
pp. 903-908 ◽  
Author(s):  
Alicja Ryta ◽  
Michal Chmielewski ◽  
Alicja Debska-Slizien ◽  
Piotr Jagodzinski ◽  
Malgorzata Sikorska-Wisniewska ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Adequacy

Dialysis adequacy and kinetics

2000 ◽  
Vol 9 (6) ◽  
pp. 599-605 ◽  
Author(s):  
John T. Daugirdas
Keyword(s):  
Dialysis Adequacy

scholarly journals Erratum to: Dialysis adequacy in peritoneal dialysis

2014 ◽  
Vol 27 (5) ◽  
pp. 599-599
Author(s):  
Giovambattista Virga ◽  
Vincenzo La Milia ◽  
Giovanni Cancarini ◽  
Massimo Sandrini
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Adequacy
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