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Background and Objectives: Intravenous immunoglobulin (IVIG) is one of the most costly and limited‐supply blood products. Judicious use of this therapy is important to ensure a continued supply is available for patients in need. The Saskatchewan IG Stewardship Program was initiated to monitor and reduce inappropriate IG use. Materials and Methods: The Program was developed and implemented through the collaborative efforts of a multidisciplinary, inter‐organizational team. Funding was provided from provincial organizations to create new positions within the Program and to support stakeholder engagement throughout the process of implementation. Data were collected from local and national databases regarding the amount of IVIG used and appropriateness of orders based on published criteria. Results: Over 20 months, the Program helped to reduce unnecessary IVIG use from pre‐intervention levels by more than 20%. Interventions from nurse navigators alone reduced inappropriate IVIG use by 2.6%. During the 20‐month period following Program initiation, more than 4 million CAD less was spent on IVIG compared with the previous 20 months. Conclusion: The Saskatchewan IG Stewardship Program has led to more appropriate IVIG use across the province, more effective preservation of this limited healthcare resource, and cost savings that more than cover the cost of administering the Program. [ABSTRACT FROM AUTHOR]

Aim: Chronic kidney disease is a critical condition with considerable public health implications. It affects a significant proportion of the general population and when progressive, has an increasing influence on morbidity and mortality. The main purpose of this study was to explore the distribution and trends of renal replacement therapy and vascular access practice patterns among Saskatchewan end stage renal disease patients. Material and Method: This is a registry-based retrospective observational study. Prevalence of patient's on renal replacement therapy in the Canadian Organ Replacement Register who has information for renal replacement therapy from 2006 to 2016 in the province of Saskatchewan. The composite of demographics, mortality, type of renal replacement therapy, type of vascular access and important blood markers ranges were recorded among both haemodialysis and peritoneal dialysis patients. Results: From 2006 through 2016, a total of 2103 patients with mean age of 69.52±13.2 initiated renal replacement therapy in Saskatchewan. Among those patients, over half of the patients were female (62%). Majority of the patients were Caucasians and Aboriginals. Nearly two third of them were overweight and obese. Less than half developed end stage renal diseases secondary to diabetes and 14.9% had a primary diagnosis of glomerulonephritis. At the end of 2015, prevalence of end-stage kidney disease patients was 1330 in the Saskatchewan. During 2006 to 2016, 72.3% received haemodialysis, 22.8% received peritoneal dialysis, and, catheter was the most frequently used dialysis access method (64.6%). Conclusion: An increasing number of patients with advanced renal disease are being initiated on long-term dialysis every year. Haemodialysis and peritoneal dialysis are the two main types of dialysis provided under renal care programs. Alarmingly, in Saskatchewan, catheter was the most frequently used dialysis access method. [ABSTRACT FROM AUTHOR]

Objective This study aimed to compare the impact of saline lock to running a slow continuous infusion to-keep-vein-open (TKVO) on the total time a peripheral intravenous (PIV) catheter remained patent. Method A retrospective chart review of all children admitted to the paediatric ward of a regional hospital in Saskatchewan December 1, 2013 through February 28, 2014. Characteristics of patients with PIV catheters were abstracted from the health records, including patient size, catheter size and site, and total time each PIV catheter spent (i) infusing therapeutic fluids or medications, (ii) running a TKVO infusion, or (iii) saline locked. The duration of catheter patency was compared with the proportion of time that TKVO infusions were run, as well as patient gender and age. Results During 375 admissions, there were 189 PIVs which met inclusion criteria. The proportion of nontherapeutic time a PIV catheter spent TKVO compared to saline locked did not affect the total time the PIV catheter was patent (P=0.33). Gender had no influence, but older age, a nonmodifiable factor, was associated with increased time a PIV catheter remained patent (P=0.028). Discussion Peripheral intravenous (PIV) catheter insertion can be a painful and traumatic procedure. On the paediatric ward of a regional hospital, TKVO infusions were not superior to saline lock for prolonging PIV catheter patency. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: None declared.

Objective: This study aimed to compare the impact of saline lock to running a slow continuous infusion to-keep-vein-open (TKVO) on the total time a peripheral intravenous (PIV) catheter remained patent., Method: A retrospective chart review of all children admitted to the paediatric ward of a regional hospital in Saskatchewan December 1, 2013 through February 28, 2014. Characteristics of patients with PIV catheters were abstracted from the health records, including patient size, catheter size and site, and total time each PIV catheter spent (i) infusing therapeutic fluids or medications, (ii) running a TKVO infusion, or (iii) saline locked. The duration of catheter patency was compared with the proportion of time that TKVO infusions were run, as well as patient gender and age., Results: During 375 admissions, there were 189 PIVs which met inclusion criteria. The proportion of nontherapeutic time a PIV catheter spent TKVO compared to saline locked did not affect the total time the PIV catheter was patent (P=0.33). Gender had no influence, but older age, a nonmodifiable factor, was associated with increased time a PIV catheter remained patent (P=0.028)., Discussion: Peripheral intravenous (PIV) catheter insertion can be a painful and traumatic procedure. On the paediatric ward of a regional hospital, TKVO infusions were not superior to saline lock for prolonging PIV catheter patency., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Loin pain hematuria syndrome (LPHS) is characterized by severe unilateral or bilateral loin pain that suggests a renal origin but occurs in the absence of identifiable or relevant urinary tract disease. Hematuria can either be microscopic or macroscopic, but the renal abnormalities responsible for the hematuria are unexplained. Debilitating pain refractory to conventional pain medications is the main cause of morbidity., Methods: We conducted a single-arm, single-center study. Twelve patients between the ages of 21 and 62 years (11 female, 1 male) with LPHS underwent endovascular ablation of the renal nerves between July 2015 and November 2016, using the Vessix renal denervation system. The primary objective was to achieve 30% reduction in self-reported pain with the McGill Pain Questionnaire (MPQ) at 6 months. The secondary objectives were to measure changes in disability (Oswestry Disability Index [ODI]), mood (Geriatric Depression Scale [GDS]), and quality of life (EuroQol-5D [EQ-5D] and the MOS 36-Item Short Form Survey [SF-36]) scores from baseline to 6 months postprocedure., Results: Ten of 12 patients at 3 months and 11 of 12 patients at 6 months reported a >30% reduction in pain based on the MPQ at 3 and 6 months. We found consistent improvements in MPQ, ODI, GDS, EQ-5D, and SF-36 scores from baseline to 6 months postprocedure., Conclusion: We conclude that renal denervation is associated with a considerable improvement in pain, disability, quality of life, and mood. Our results suggest that percutaneous catheter-based delivery of radiofrequency energy is a safe, rapid treatment option that should be considered in all patients with LPHS.