Long-term results of thigh arteriovenous dialysis grafts.

Introduction:: A proportion of hemodialysis patients exhaust all options for arteriovenous access in upper extremities. Arteriovenous thigh grafts are a potential vascular access option in such patients.

Methods:: We performed a retrospective study of all thigh arteriovenous access grafts placed between 1995 and 2015.

Hemodialysis patients' satisfaction and perspectives on complications associated with vascular access related interventions: are we listening?

Purpose: To understand the patient's perspective on complications associated with vascular access-related interventions.

Methods: A multi-stage comprehensive questionnaire of over 150 items was administered to 140 in-center hemodialysis patients in a large, Toronto-based academic-based facility from May 1, 2011 until July 1, 2014. The questionnaire was divided into three domains: physical complications, disruption to routine, and infection.

The stuck catheter: a hazardous twist to the meaning of permanent catheters.

Introduction: Permanent central venous catheter use is associated with significant complications that often require their timely removal. An uncommon complication is resistant removal of the catheter due to adherence of the catheter to the vessel wall. This occasionally mandates invasive interventions for removal.

Measuring patient satisfaction with vascular access: vascular access questionnaire development and reliability testing.

Purpose: The primary objective of this study is to measure hemodialysis patients' satisfaction with their vascular access. The secondary objective is to evaluate the measurement tool's psychometric properties to assess patient satisfaction with their vascular access.

Methods: We generated a comprehensive list of survey items related to patients' views and satisfaction with their vascular access and administered it to participating in-center hemodialysis patients over 4 months.

Using tunneled femoral vein catheters for "urgent start" dialysis patients: a preliminary report.

Background: Multiple benefits of arteriovenous fistulas (AVF) and arteriovenous grafts (AVGs) exist over catheters. As part of a strategy to preserve thoracic venous sites and reduce internal jugular (IJ) vein catheter use, we inserted tunneled femoral vein catheters in incident "urgent start" dialysis patients while facilitating a more appropriate definitive dialysis access.

Methods: "Urgent start" dialysis patients between January 15, 2013 and January 15, 2014 who required chronic dialysis, and did not have prior modality and vascular access plans, had tunneled femoral vein catheters inserted.

Seeing eye to eye: the key to reducing catheter use.

Purpose: Hemodialysis central venous catheters (CVCs) are increasingly used, despite a prevalence target of <10%. The primary aim of our study was to understand why patients persistently use their CVCs.

Methods: A multicenter prospective observational study surveyed 322 patients and their vascular access coordinators (VACs) to determine the reasons patients use CVCs.

Long-term follow-up of the Hemodialysis Infection Prevention with Polysporin Ointment (HIPPO) Study: a quality improvement report.

Background: Infection is a common and serious complication in hemodialysis patients accessed using central venous catheters (CVCs). Previously, a randomized double-blinded trial (HIPPO [Hemodialysis Infection Prevention With Polysporin Ointment] Study) showed that application of a topical polyantibiotic ointment at the CVC exit site decreased CVC-related infections, including bacteremias and their adverse consequences. Based on this study's results, our institution implemented a policy of routine topical polyantibiotic ointment application for CVC-related infection prophylaxis.

Hemodialysis catheter care: current recommendations for nursing practice in North America.

Vascular access is essential for hemodialysis (HD). Many patients require a catheter for HD, either long-term or short-term, if they do not have a functional fistula or graft. Catheter-related complications, such as bacteremias and catheter dysfunction, can be reduced with consistent use of recommended practices for catheter management.

Trisodium citrate 4%--an alternative to heparin capping of haemodialysis catheters.

Background: Central venous catheters (CVCs) continue to be used at a high rate for dialysis access and are frequently complicated by thrombus-related malfunction. Prophylactic locking with an anticoagulant, such as heparin, has become standard practice despite its associated risks. Trisodium citrate (citrate) 4% is an alternative catheter locking anticoagulant.

Arteriovenous fistula outcomes in the era of the elderly dialysis population.

Background: The growth of patients > or =65 years on hemodialysis is increasing. Guidelines recommend arteriovenous fistula (AVF) access but their outcomes in elderly patients are controversial. This study compared the outcomes of AVF in patients <65 years old (65- group) versus those > or =65 years old (65+ group).

Reducing vascular access morbidity: a comparative trial of two vascular access monitoring strategies.

Background: Thrombosis is the primary cause of access failure in polytetrafluoroethylene grafts and arteriovenous fistulas. It can lead to significant patient and access morbidity and mortality, and is difficult to prevent medically. Intervention is largely limited to maximizing access patency by detecting culprit lesions early and intervening with angioplasty or surgical revision.