Background: Although vascular access is essential for adequate haemodialysis delivery, the systematic use of a patient's venous patrimony may eventually lead to exhaustion of suitable sites for placement of a new vascular access. Case Report: We present two cases of such patients. In the first one we inserted a 55cm catheter through the left external iliac vein, and a 40cm translumbar catheter ...

Aeromonas infection in humans is associated with certain underlying diseases, especially chronic liver disease or malignancy. However, Aeromonas infection associated with iron overload is rarely reported. We report a case of a 47-year-old female with end-stage renal disease on haemodialysis and on deferoxamine treatment for iron overload who developed Aeromonas sepsis with septic embolism and r...

There has been a resurgence in home haemodialysis over the last decade and interest in online haemodiafiltration in gaining momentum with advances in technology and the results of recent clinical trials. Both increasing haemodialysis frequency and treatment time have a number of potential benefits in improving dialysis efficiency and are ideally placed in the home setting. This chapter describe...

adherence in our haemodialysis unit and similarly found that the duration of time these catheters were left in-situ was considerable, ranging from 1 to 10 years. Two of the catheters were removed under general anaesthetic by an experienced surgeon and the other catheters were ligated proximally and buried. With the increasing use of tunnelled haemodialysis catheters for long-term access in chro...

Health care policy is encouraging expansion of home haemodialysis, aiming to improve patient outcomes and reduce cost. However, most patient outcome data derive from retrospective observational studies, with all their inherent weaknesses. Conventional thrice weekly home haemodialysis delivers a 22-51% reduction in mortality, but why should that be? Frequent and/or nocturnal haemodialysis reduce...

Vascular access is still the 'Achilles heel' in the haemodialysis treatment. Access-related problems account for approximately 25% of hospitalizations in haemodialysis patients. In patients lacking a suitable vascular anatomy or presenting repeated a-v fistula thrombosis due to vascular problems and/or hypotension, a permanent central venous catheter can establish a reliable long-term vascular ...

INTRODUCTION Vancomycin-resistant enterococci (VRE) among haemodialysis patients has increased rapidly and, to date, there is no report of this incidence in Portugal. METHODS A total of 121 faecal samples were collected from haemodialysis patients, and then tested for VRE. Antimicrobial resistance, virulence and multilocus sequence typing (MLST) were studied. RESULTS VRE prevalence was 3.3%...

Background & Objectives: Recently published IDSA guidelines on vancomycin dosing no longer advocates the use of trough concentrations as surrogate markers for clinical efficacy. Protocols developed prior to revised targets may not reflect true efficacy marker that is AUC/MIC 400-600. This study aimed evaluate local protocol in achieving target concentration and extrapolated 400-600 patients...

A 62-year-old man, receiving chronic haemodialysis and suffering from alcoholic liver cirrhosis and chronic pancreatitis, presented with hypoglycaemic coma. Plasma cortisol was undetectable (< 5.5 nmol/L) with suppressed adrenocorticotropic hormone (ACTH), which established a diagnosis of adrenal failure due to ACTH deficiency. Twenty-five milligrams of oral hydrocortisone eradicated hypoglycae...