Search

Background: This study aimed to report the 12‐month results of drug‐eluting stent (DES) for the treatment of significant restenosis of the hemodialysis access. Materials and methods: A total of 14 patients (seven men and seven women; median age 70 years; range of 50–83 years) with significant restenosis of hemodialysis accesses were enrolled from January 2017 to December 2018. A total of 10 arteriovenous graft (AVG) and four arteriovenous fistulae were treated with DES. Study outcomes included primary patency of the target lesion and circuit. Results: Venous anastomosis of the AVG was the most common target lesion for DES insertion (nine hemodialysis accesses). The range of follow‐up time was 12–36 months. Primary patency rates of target lesion before DES (patency for last conventional balloon angioplasty [CBA]) versus target lesion after DES at 6 and 12 months were 29% versus 100% and 7% versus 86% (p < 0.001). Primary patency rates of pre‐DES circuit (patency for last CBA) versus post‐DES circuit at 6 and 12 months were 29% versus 64% and 7% versus 29%, respectively (p = 0.058). Conclusion: DES might improve the patency rate of target lesion in patients with significant restenosis of the hemodialysis access. [ABSTRACT FROM AUTHOR]

Background & objective: Cytokine storms play a significant role in conditions leading to multi-organ failure in patients with severe corona virus disease-2019 (COVID-19). The eradication of pro-inflammatory cytokines through hemoperfusion has been suggested to be a possible strategy to improve outcomes in these patients. We evaluated the impact of adjunctive HA330 hemoperfusion on outcomes in severe COVID-19 patients. Methodology: A single-center retrospective cohort study was conducted from December 2021 to December 2022. We included severe COVID-19 patients with elevated pro-inflammatory markers, who received three consecutive sessions of HA330 hemoperfusion in addition to the standard treatment protocol. Clinical data, including demographic information, baseline characteristics, and treatment outcomes, were analyzed. Results: We evaluated 24 severe COVID-19 patients. We observed a significant reduction in levels of CRP (P < 0.001) and IL-6 (P = 0.042), as well as a significant increase in arterial partial pressure of oxygen (P = 0.041). Importantly, no patient experienced cytotoxicity after the HA330 hemoperfusion sessions, confirming the biocompatibility of the treatment. Conclusion: Three consecutive sessions of HA330 hemoperfusion, used as an adjunctive therapy to standard care in severe COVID-19 patients, effectively reduced pro-inflammatory cytokine levels and improved oxygenation. However, large multicenter trials are required to validate these clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the association between admission-corrected serum calcium phosphate (CaPO 4 ) levels and the risks of in-hospital acute kidney injury (AKI) and mortality, hypothesizing a dose-dependent relationship between serum CaPO 4 concentrations and the likelihood of developing AKI., Methods: This large retrospective cohort study analyzed hospitalized adult patients who had serum calcium, phosphate, and albumin levels measured within 24 hours of admission between January 2014 and December 2018. Piecewise regression was employed to identify the optimal CaPO 4 cutoff values for predicting in-hospital AKI and mortality. Subsequently, the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the risks of in-hospital AKI and mortality associated with these cutoff values., Results: A total of 2,116 patients were included in the study. The incidence rates of AKI for patients with CaPO 4 levels ≤27 and >27 mg 2 /dL 2 were 9.6% and 10.9%, respectively. The bilinear association pattern revealed the lowest risk of AKI at a CaPO 4 level of 27 mg 2 /dL 2 . Piecewise regression analysis showed that each 1 mg 2 /dL 2 increase in CaPO 4 level above the 27 mg 2 /dL 2 cutoff was associated with increased risks of in-hospital AKI and mortality, with OR of 1.048 (95% CI: 1.030-1.065) and 1.048 (95% CI: 1.032-1.065), respectively., Conclusion: Our findings indicate a critical relationship between elevated serum CaPO 4 levels and increased risks of in-hospital AKI and mortality, with a notable cutoff at CaPO 4 >27 mg 2 /dL 2 ., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of the Prince of Songkla University issued approval 62-175-14-4. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jetanapirom et al.)

Background: Native arteriovenous fistula is one of the important routes for hemodialysis patients because of increased long-term survival and preservation of quality of life. We reported on a single-center experience with using pharmacomechanical thrombolysis for the treatment of thrombosed native arteriovenous fistula., Material/methods: This was a retrospective study of 12 hemodialysis patients (8 males and 4 females) with 14 thrombosed distal forearm Brescia-Cimino radiocephalic fistulas who were referred for pharmacomechanical thrombolytic treatment in the intervention unit of the Radiology Department, from 1 January 2010 to 30 December 2011. Demographic data, technical success rates, clinical success rates and complications were evaluated. The patency was evaluated by Kaplan-Meier analysis., Results: The technical and clinical success was found in 12 thrombosed fistulas. Only 3 procedures had minor complications including small amounts of adjacent soft tissue hematoma. There were no procedure-related major complications. The primary patency rates at 6 and 12 months were 67% and 50%. The secondary patency rates at 6 and 12 months were 75% and 67%., Conclusions: Pharmacomechanical thrombolysis is a minimally invasive, effective, durable, and safe procedure for the treatment of thrombosed native arteriovenous fistula. This procedure can be considered as an alternative treatment for thrombosed dialysis fistulas.