Recognizing Common Skin and Soft Tissue Infections in the Nephrology Clinic

Velde-Kossmann, Karen M Van de

doi:10.1159/000494594

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…57 The risk of wound complications is further increased if the patient has concomitant diabetes mellitus. 58 Patients with ESRD also have an increased risk of perioperative bleeding and requiring blood transfusions, as highlighted in a meta-analysis by Acedillo et al 59 The increased risk of perioperative bleeding can be attributed to ESRD-related platelet dysfunction and coagulopathy, as well as the presence of abnormal venous collaterals in the chest wall due to CVOD. The incidence of postoperative complications reported in our study, such as surgical site infections, appears to be consistent with other studies that evaluated postoperative complications in cardiothoracic surgery.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

et al. 2022

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Introduction: Central venous occlusive disease (CVOD) is a complication that can occur in patients with end-stage renal disease who are receiving hemodialysis. When CVOD develops, patients often require multiple re-interventions to maintain their dialysis access. CVOD can be treated by various strategies such as balloon angioplasty, stenting, lower limb or extra-anatomical grafts, hybrid grafts or surgical bypasses such as right atrial (RA). In this systematic review, we aim to evaluate the indications, technical aspects, and outcomes after RA bypass grafting for the treatment of CVOD in hemodialysis patients. Methods: A systematic and comprehensive literature search was conducted using various electronic databases. We included articles that reported described and reported outcomes of RA bypass grafting for the treatment of CVOD in hemodialysis patients. A narrative review of the indications and technical aspects of RA bypass grafting was performed. We also pooled and reported the primary patency, secondary patency, postoperative complications, and 30-day mortality of RA bypass grafting. Results: A total of 21 studies with 55 patients who underwent RA bypass grafting were included in our systematic review. Follow-up period ranged from 0.5 to 84 months. The mean pooled primary patency and secondary patency of RA bypass grafting were 8.1 ± 4.9 and 21.7 ± 20.1 months, respectively. The incidence of early postoperative complications such as surgical site infection, bleeding, and access thrombosis was 0%, 4%, and 4%, respectively. The overall 30-day mortality was 4%. Conclusions: This systematic review summarizes the patient characteristics, technical features and outcomes of RA bypass grafting in the treatment of hemodialysis-related CVOD. RA bypass grafting may be a viable last-resort option when less invasive or conventional treatment options have been exhausted.

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Section: Discussionmentioning

confidence: 99%

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

et al. 2022

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“…Patients with ESRD require dialysis for survival and have a higher risk of infection due to multiple factors, including a combination of immune system dysfunctions from uremia, as well as complications associated with their required vascular access [ 10 , 11 ]. In the ESRD population, infectious disease is considered the second leading cause of mortality, only behind cardiovascular disease [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Pressure Ulcer Diagnosis Is Associated with Increased Mortality in Patients with End-Stage Renal Disease: A Retrospective Study

Duchesne

Waller

Baer

et al. 2023

Life

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Pressure ulcers are associated with multiple comorbidities and annually affect approximately 3 million Americans, directly accounting for approximately 60,000 deaths per year. Because patients with end-stage renal disease (ESRD) are known to present with unique factors which impair wound healing, pressure ulcers diagnosed in ESRD patients might independently increase the risk of mortality. To investigate the association between pressure ulcer diagnosis and mortality risk in the ESRD population, a retrospective analysis of the United States Renal Data System (USRDS) database was performed. The records of 1,526,366 dialysis patients who began therapy between 1 January 2005 and 31 December 2018 were included. Our analysis showed that the diagnosis of pressure ulcers in this population was independently associated with mortality even after controlling for confounding factors (p < 0.001). A Kaplan–Meier survival analysis demonstrated reduced survival in patients with a pressure ulcer diagnosis compared to those without a pressure ulcer diagnosis. These results establish pressure ulcers as a significant independent risk factor for mortality, as well as suggesting several comorbidities as potential risk factors for pressure ulcers in the ESRD population.

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An effective treatment for diabetic foot necrosis with traditional Chinese and Western medicine: a case report

Liang,

Xu,

Zhang

et al. 2024

J Wound Care

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Patients with diabetes who undergo a kidney transplant are at a great risk of undergoing amputations, usually associated with severe infection and necrosis. The treatment of severe diabetic foot necrosis is challenging in clinic, and the function of the limb is often hugely compromised. A 74-year-old male who had been diagnosed with severe post-renal transplant diabetic foot necrosis refused the option of below-knee amputation from previous surgeons, and requested to keep his left foot. The patient was treated with integrated traditional Chinese medicine (TCM) and Western medicine, with positive results. TCM therapeutic principles included ‘clearing heat, removing toxicity, regulating Qi, resolving dampness, activating stagnant blood and nourishing yin as well as tonifying Qi and blood’. Treatment with Western medicine included wound debridement, internal fixation or joint fusion, and use of insulin, antibiotics and vasodilators. The patient was treated with a staged and diverse approach (i.e., a combination of TCM and Western medicine, surgical management and education for diabetic foot care), which ultimately helped the patient achieve limb salvage and regain normal function. A combination therapy of Western medicine and TCM may be a promising approach to heal diabetic foot ulcers.

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Recognizing Common Skin and Soft Tissue Infections in the Nephrology Clinic

Cited by 4 publications

References 19 publications

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

Pressure Ulcer Diagnosis Is Associated with Increased Mortality in Patients with End-Stage Renal Disease: A Retrospective Study

An effective treatment for diabetic foot necrosis with traditional Chinese and Western medicine: a case report

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