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  • 11
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    Online Resource
    Early results and medico-economic evaluation of a short daily home hemodialysis program in a Private hemodialysis center
    Registre de Dialyse Peritoneale de Langue Francaise (RDPLF) ; 2021
    In:  Bulletin de la Dialyse à Domicile Vol. 4, No. 2 ( 2021-05-20), p. 105-119
    Details
    In: Bulletin de la Dialyse à Domicile, Registre de Dialyse Peritoneale de Langue Francaise (RDPLF), Vol. 4, No. 2 ( 2021-05-20), p. 105-119
    Abstract: Abstract: Between 2015 and 2017 there was a 40% increase in daily hemodialysis, according to the REIN database. This increase concerns 1% of patients and the private sector remains under-represented. Our retrospective study aims to describe the clinical features, the organizational and medico-economic specificities of this technique in a private hemodialysis center. Methods: We included 12 dialyzed patients trained on Nx Stage® machine from February 2020 to April 2021. Data were retrospectively obtained through review of our electronic medical records (EUCLID®). Results: Of the 12 patients trained, 11 dialyzed from home, with an average follow-up of 9 months (1-14). The average age was 45 with a sex ratio of 4/8 (M/W), and a median Charlson score of 3 (2-4). The average residual urinary output was 700 mL/24h, and 50% of patients were anuric. 100% of patients had an arteriovenous fistula and were cannulated using the buttonhole technique. 9 patients are on a transplant list. One patient needed anticoagulants. The mean training time was 35 days (28-35). 83% of patients were dialyzed 6 days a week with an average duration of 210 minutes (130-150) per session. The average volume of dialysate was 24.85 liters. One patient developed an allergy to the PUREMA® membrane. Pre-dialytic hemoglobin, serum creatinine, urea, phosphoremia and B2-microglobuline are stable at 9 months with improvement in metabolic acidosis. Conclusion: DHHD allowed a better socio-professional integration. One patient received a transplant and 3 patients resumed professional activity.
    Type of Medium: Online Resource
    ISSN: 2607-9917
    URL: Article
    DOI: 10.25796/bdd.v4i2.61653
    Language: Unknown
    Publisher: Registre de Dialyse Peritoneale de Langue Francaise (RDPLF)
    Publication Date: 2021
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  • 12
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    Impact of First Wave COVID-19 Crisis on Dialysis Parameters of COVID-Free Hemodialysis Patients: A NephoCare France Longitudinal Retrospective Cohort Study
    S. Karger AG ; 2022
    In:  Blood Purification Vol. 51, No. 6 ( 2022), p. 531-539
    Details
    In: Blood Purification, S. Karger AG, Vol. 51, No. 6 ( 2022), p. 531-539
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Chronic hemodialysis (HD) patients are at high risk of severe COVID-19 with a high risk of death. The organization of dialysis units to treat chronic HD patients with COVID-19 is demanding to prevent virus transmission both in COVID-free patients and the staff. These constraints may have an impact on the dialysis delivery to COVID-free HD patients. We report our experience in French NephroCare (NC) centers. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We report retrospectively dialysis and nutritional indicators among COVID-free prevalent chronic HD patients’ cohort treated in French NC units from February 2020 to April 2020. The COVID-free HD patients were split into 2 subgroups for the analysis, Paris region and other regions because the incidence of COVID-19 was different according to the French regions. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The Paris region was the most impacted by COVID-19 with 73% of all the contaminations that occurred in French NC units ( 〈 i 〉 n 〈 /i 〉 = 118). The dialysis frequency was not reduced all over the NC regions. 2,110 COVID-free HD patients were split into 2 subgroups including Paris region (748 patients) and other regions (1,362 patients). The weekly treatment time decreased significantly in Paris region from February to April (723–696 min [ 〈 i 〉 p 〈 /i 〉 & #x3c; 0.00001]) but remained stable in the other regions. The processed blood volume, KT/V, and convective volume declined significantly in the Paris region subgroup but not in other regions. The 3-month weight loss significantly increased in the whole group of patients whatever the region from 0.0 to 0.2% between February 2020 and April 2020 ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.00001). Ultrafiltration rate (UFR) and the normalized proteic catabolic rate remained stable all along the period. The stepwise regression analysis identified February serum albumin level and April UFR as negatively associated with 3-month weight loss. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 HD delivery to COVID-free HD patients was negatively impacted in the Paris region because of the strong constraints on units’ organization related to the treatment of COVID-19+ HD patients and with a higher proportion of limited care/self-care units with less staff resources. The 3-month weight loss increase may be related to the suppression of intradialytic snack that impacted mostly the more malnourished patients or patients with lower interdialytic weight gain. These consequences of the COVID-19 crisis on COVID-free HD patients must be recognized and corrected to prevent further deleterious effects on patients’ outcomes.
    Type of Medium: Online Resource
    ISSN: 0253-5068 , 1421-9735
    URL: Article
    DOI: 10.1159/000517493
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482025-0
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  • 13
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    Efficacy and Safety of Intra-gastric Balloon Placement in Dialyzed Patients Awaiting Kidney Transplantation
    Springer Science and Business Media LLC ; 2019
    In:  Obesity Surgery Vol. 29, No. 2 ( 2019-2), p. 713-720
    Details
    In: Obesity Surgery, Springer Science and Business Media LLC, Vol. 29, No. 2 ( 2019-2), p. 713-720
    Type of Medium: Online Resource
    ISSN: 0960-8923 , 1708-0428
    URL: Article
    DOI: 10.1007/s11695-018-3574-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2087903-9
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  • 14
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    Perioperative ultrasound: a critical element in diagnosis and salvage of complex vascular access dysfunction
    SAGE Publications ; 2017
    In:  The Journal of Vascular Access Vol. 18, No. 4 ( 2017-07), p. 359-361
    Details
    In: The Journal of Vascular Access, SAGE Publications, Vol. 18, No. 4 ( 2017-07), p. 359-361
    Abstract: Perioperative ultrasound performed by the operative surgeon can improve outcomes of vascular access surgery. We present the case of a patient referred for dysfunctional vascular access with two separate and patent right arm arteriovenous fistulas (AVF). Pre-operative ultrasound vessel mapping defined the complex anatomy and intraoperative ultrasound allowed the optimal surgical approach for access salvage while avoiding the need for catheter placement. Case report A 45-year-old male patient of African descent presented with a malfunctioning right forearm AVF and aneurysm formation in the arm. Clinical examination revealed a soft, low-flow forearm fistula merging into a high-flow and pulsatile AVF outflow aneurysm in the arm. Multiple well healed surgical incisions were present. Ultrasound examination revealed two separate AVFs. One was a low-flow radiocephalic AVF at the wrist that was used routinely for cannulation in the forearm, although with some difficulty due to low inflow pressure. The second AVF, a brachiocephalic anastomosis, was pulsatile, aneurysmal, and not in use. Blood flow in the proximal brachial artery was 3.0 L/min. Surgeon-performed ultrasound (SP-US) was used perioperatively to plan the surgical approach and incision, closing the existing brachial anastomosis and creating a veno-venous anastomosis between both outflow veins, establishing a mature and undisturbed cannulation conduit from the wrist through the arm. The revised AVF was immediately usable for hemodialysis with restored normal AVF flow in the forearm and appropriately reduced flow in the arm. Importantly, dialysis catheter placement was avoided.
    Type of Medium: Online Resource
    ISSN: 1129-7298 , 1724-6032
    URL: Article
    DOI: 10.5301/jva.5000731
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2079292-X
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  • 15
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    MO674SHORT DAILY HOME HEMODIALYSIS PROGRAM, IN NEPHROCARE HEMODIALYSIS CENTER: REPORT STUDY
    Oxford University Press (OUP) ; 2021
    In:  Nephrology Dialysis Transplantation Vol. 36, No. Supplement_1 ( 2021-05-29)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 36, No. Supplement_1 ( 2021-05-29)
    Abstract: Several studies showed that DHHD improved survival and quality of life and allowed a lower cost for health system. The aim of this study was to describe our first experience of DHHD in our dialysis center. Method We included 9 dialyzed patients trained on Nx Stage® machine (Fresenius Medical Care) from February to December 2020. Data was retrospectively obtained through review of our medical electronic records (Euclid®). Results Among 9 patients trained, 8 were installed at home, with an average follow up of 7 months. 6 patients were dialyzed in self hemodialysis facilities. The mean age was 45 years (28-71), 6 women, BMI: 24 kg/m2 (21-30), dialysis vintage: 5 years and 7 patients are on transplant list. The Charlson score was: 5 (4-8), 5 patients had a residual diuresis & gt; 500 ml/d. The average training duration was 5 weeks (4-8). Our training program targeted the self-puncture of AVF and the self-assembly of the machine by the patient. 100% of AVF were cannulated through Buttonhole technique. 6 patients were dialyzed 6 times a week and only one patient needed anticoagulants. The blood pressure improved on the first days of DHHD (↓ 50% of drugs for 50% of patients). Hemoglobin level maintained between 10-12 g/dl with ↓ EPO. The mineral metabolism status was improved for all patients, with stopping of binders in one case. DHHD reduced symptoms like fatigue, cramping and post-dialysis recovery for all patients, and allowed for patients a better socio-professional integration. A medico-economic analysis is conducted. Conclusion DHHD improved blood pressure, anemia, mineral status and quality of life. Through economy in medicaltransport and better socio-professional integration DHD provides savings for the health system
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfab099.0019
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1465709-0
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  • 16
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    Gestion de la crise COVID-19 dans une organisation multicentrique de dialyse au cours des trois premières vagues : retour d’expérience de NephroCare France
    John Libbey Eurotext ; 2022
    In:  Néphrologie & Thérapeutique Vol. 18, No. 1 ( 2022-02), p. 21-28
    Details
    In: Néphrologie & Thérapeutique, John Libbey Eurotext, Vol. 18, No. 1 ( 2022-02), p. 21-28
    Type of Medium: Online Resource
    ISSN: 1769-7255
    URL: Article
    DOI: 10.1016/j.nephro.2021.09.004
    Language: French
    Publisher: John Libbey Eurotext
    Publication Date: 2022
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  • 17
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    Arteriovenous fistulas thrombosis in hemodialysis patients with COVID-19
    SAGE Publications ; 2022
    In:  The Journal of Vascular Access Vol. 23, No. 3 ( 2022-05), p. 412-415
    Details
    In: The Journal of Vascular Access, SAGE Publications, Vol. 23, No. 3 ( 2022-05), p. 412-415
    Abstract: The current Coronavirus disease 2019 (COVID-19) outbreak is associated with significant mortality, especially in patients suffering from end stage renal disease (ESRD) and hemodialysis patients. Several previous studies reported an over-risk of arterial and venous thrombosis, in particular pulmonary embolism and venous thrombosis of catheter in COVID19 patients in intensive care unit. However, arteriovenous fistula (AVF) thrombosis has rarely been reported yet in these patients. AVF thrombosis is a serious complication that impacts significantly patients outcome. Here, we aim to describe characteristics and prognosis of a cohort of COVID-19 hemodialysis (HD) patients presenting with AVF thrombosis. Methods: In the Ile de France region (Paris area) during the March 11th–April 30th 2020 period, fistula thrombosis cases were collected among COVID-19 hemodialysis patients in seven dialysis units and in interventional vascular departments. These patients’ characteristics were analyzed through a review of the patient’s medical records. Results: Seventeen patients were included in our study (median age 69 years). Ten patients (59%) were men. Ten patients (59%) were diabetic and 88% had a high blood pressure. The mortality rate in these patients was 47%. All thrombosis treated with a declotting procedures (64%) were successfully cleared, but with early relapse in 36%. Conclusion: Our study highlights AVF thrombosis as a severe complication in COVID-19 hemodialysis patients that contributed to the severity and accelerated death.
    Type of Medium: Online Resource
    ISSN: 1129-7298 , 1724-6032
    URL: Article
    DOI: 10.1177/1129729821996091
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2079292-X
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