“Save the Vein” Initiative in Children With CKD: A Quality Improvement Study

Singh, Nisha S; Grimes, JoLynn; Gregg, Gina K; Nau, Amy; Rivard, Douglas C.; Fields, Moriah; Flaucher, Nicholas; Sherman, Ashley; Williams, Maria; Wiley, Kaylene J; Kerwin, Kristen; Warady, Bradley A.

doi:10.1053/j.ajkd.2020.11.016

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…Arteriovenous fistulas are the recommended access for pediatric patients who will not receive a kidney transplant in 1 year or longer. 5 It has been shown that AVFs are associated with lower rates of infection, access dysfunction, and need for access replacement when compared to central venous catheters. 4,5 However, not all patients are candidates for AVF creation, and therefore hemodialysis catheters play an important role in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…5 It has been shown that AVFs are associated with lower rates of infection, access dysfunction, and need for access replacement when compared to central venous catheters. 4,5 However, not all patients are candidates for AVF creation, and therefore hemodialysis catheters play an important role in the pediatric population. Patients with a venous ECMO cannula in place already have a venotomy site that can be used to place a hemodialysis catheter without the need to involve another central vein.…”

Section: Discussionmentioning

confidence: 99%

“…The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative recommends protection of all peripheral and central veins from damage whenever possible avoiding unnecessary venipunctures in patients that will require dialysis in the future. 5,6 With the importance of vein preservation and the possibility of renal failure during or after ECMO, data regarding transition from ECMO cannulation to temporary or permanent hemodialysis in pediatric patients that will require long-term dialysis is not currently available. We aim to describe the outcomes of venous ECMO cannula exchange for either temporary with transition to PD or permanent hemodialysis catheters in children requiring RRT to promote vein preservation.…”

Section: Introductionmentioning

confidence: 99%

“…In children requiring RRT, central venous catheters are the access modality of choice in up to two-thirds of children. 4,5 Vein preservation in patients requiring prolonged RRT is crucial while they wait for a renal transplant. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative recommends protection of all peripheral and central veins from damage whenever possible avoiding unnecessary venipunctures in patients that will require dialysis in the future.…”

Section: Introductionmentioning

confidence: 99%

“…The National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative recommends protection of all peripheral and central veins from damage whenever possible avoiding unnecessary venipunctures in patients that will require dialysis in the future. 5,6…”

Section: Introductionmentioning

confidence: 99%

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Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy

Cruz-Centeno,

Stewart,

Marlor

et al. 2023

The American Surgeon™

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Background Pediatric patients requiring extracorporeal membrane oxygenation (ECMO) may require renal replacement therapy even after decannulation. However, data regarding transition from ECMO cannulation to a hemodialysis catheter in pediatric patients is not currently available. Methods Patients <18 years old who had an ECMO cannula exchanged for a hemodialysis catheter during decannulation at a tertiary care children’s center from January 2011 to September 2022 were identified. Data was collected from the electronic medical record. Results A total of 10 patients were included. The cohort was predominantly male (80.0%, n = 8) with a median age of 1 day (IQR 1.0, 24.0). All ECMO cannulations were veno-arterial in the right common carotid artery and internal jugular vein. The median time on ECMO was 8.5 days (IQR 6.0, 15.0). One patient had the venous cannula exchanged for a tunneled hemodialysis catheter during decannulation, two were transitioned to peritoneal dialysis, and seven had the temporary hemodialysis catheter converted to a tunneled catheter by Interventional Radiology (when permanent access was required) at a median time of 10 days (IQR 8.0, 12.5). Of these 7 patients, 28.6% (n = 2) developed catheter-associated infection within 30 days of replacement, with one requiring catheter replacement. Transient bloodstream infection occurred in 10.0% (n = 1) within 30 days of ECMO cannula exchange. Conclusion Venous ECMO cannula exchange for a hemodialysis catheter in children requiring renal replacement therapy after decannulation is possible as a bridge to a permanent hemodialysis or peritoneal catheter if renal function does not recover, while supporting vein preservation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy

Cruz-Centeno,

Stewart,

Marlor

et al. 2023

The American Surgeon™

Self Cite

View full text Add to dashboard Cite

show abstract

A Systematic Literature Review on the Use of Dried Biofluid Microsampling in Patients With Kidney Disease

Lamond,

Chetwynd,

Salama

et al. 2024

Clinical Laboratory Analysis

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BackgroundKidney disease is fairly unique due to the lack of symptoms associated with disease activity, and it is therefore dependent on biological monitoring. Dried biofluids, particularly dried capillary blood spots, are an accessible, easy‐to‐use technology that have seen increased utility in basic science research over the past decade. However, their use is yet to reach the kidney patient population clinically or in large‐scale discovery science initiatives. The aim of this study was to systematically evaluate the existing literature surrounding the use of dried biofluids in kidney research.MethodsA systematic literature review was conducted using three search engines and a predefined search term strategy. Results were summarised according to the collection method, type of biofluid, application to kidney disease, cost, sample stability and patient acceptability.ResultsIn total, 404 studies were identified and 67 were eligible. In total, 34,739 patients were recruited to these studies with a skew towards male participants (> 73%). The majority of samples were blood, which was used either for monitoring anti‐rejection immunosuppressive drug concentrations or for kidney function. Dried biofluids offered significant cost savings to the patient and healthcare service. The majority of patients preferred home microsampling when compared to conventional monitoring.ConclusionThere is an unmet need in bringing dried microsampling technology to advance kidney disease despite its advantages. This technology provides an opportunity to upscale patient recruitment and longitudinal sampling, enhance vein preservation and overcome participation bias in research.

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Dried Blood Spot Sampling for Monitoring Children With Immune-Mediated Glomerulopathies and After Kidney Transplantation

Brunkhorst,

Terhardt,

Bulitta

et al. 2024

Kidney International Reports

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“Save the Vein” Initiative in Children With CKD: A Quality Improvement Study

Cited by 5 publications

References 16 publications

Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy

Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy

A Systematic Literature Review on the Use of Dried Biofluid Microsampling in Patients With Kidney Disease

Dried Blood Spot Sampling for Monitoring Children With Immune-Mediated Glomerulopathies and After Kidney Transplantation

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