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Kramer A, Boenink R, Noordzij M, Bosdriesz JR, Stel VS, Beltrán P, Ruiz JC, Seyahi N, Comas Farnés J, Stendahl M, Garneata L, Winzeler R, Golan E, Lopot F, Korejwo G, Bonthuis M, Lassalle M, Slon Roblero MF, Kuzema V, Hommel K, Stojceva-Taneva O, Asberg A, Kramar R, Hemmelder MH, De Meester J, Vazelov E, Andrusev A, Castro de la Nuez P, Helve J, Komissarov K, Casula A, Magaz Á, Santiuste de Pablos C, Bubić I, Traynor JP, Ioannou K, Idrizi A, Palsson R, des Grottes JM, Spustova V, Tolaj-Avdiu M, Jarraya F, Nordio M, Ziginskiene E, Massy ZA, Jager KJ. The ERA-EDTA Registry Annual Report 2017: a summary. Clin Kidney J 2020; 13:693-709. [PMID: 32897277 PMCID: PMC7467580 DOI: 10.1093/ckj/sfaa048] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background This article presents a summary of the 2017 Annual Report of the European Renal Association–European Dialysis and Transplant Association (ERA-EDTA) Registry and describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 37 countries. Methods The ERA-EDTA Registry received individual patient data on patients undergoing RRT for ESRD in 2017 from 32 national or regional renal registries and aggregated data from 21 registries. The incidence and prevalence of RRT, kidney transplantation activity and survival probabilities of these patients were calculated. Results In 2017, the ERA-EDTA Registry covered a general population of 694 million people. The incidence of RRT for ESRD was 127 per million population (pmp), ranging from 37 pmp in Ukraine to 252 pmp in Greece. A total of 62% of patients were men, 52% were ≥65 years of age and 23% had diabetes mellitus as the primary renal disease. The treatment modality at the onset of RRT was haemodialysis for 85% of patients. On 31 December 2017, the prevalence of RRT was 854 pmp, ranging from 210 pmp in Ukraine to 1965 pmp in Portugal. The transplant rate in 2017 was 33 pmp, ranging from 3 pmp in Ukraine to 103 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2008–12, the unadjusted 5-year patient survival probability for all RRT modalities combined was 50.8%.
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Affiliation(s)
- Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Rianne Boenink
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jizzo R Bosdriesz
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Palma Beltrán
- Public Health Directorate, RERCA Registry, Oviedo, Asturias, Spain
| | - Juan C Ruiz
- Department of Nephrology, Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Jordi Comas Farnés
- Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain
| | - Maria Stendahl
- Swedish Renal Registry, Department of Internal Medicine, Jonkoping Regional Hospital, Jonkoping, Sweden
| | - Liliana Garneata
- Romanian Renal Registry, Department of Internal Medicine and Nephrology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Rebecca Winzeler
- Institute of Nephrology, Waid and Triemli City Hospital, Zurich, Switzerland
| | - Eliezer Golan
- Israel Renal Registry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - František Lopot
- Department of Medicine, General University Hospital, Prague - Strahov, Czech Republic
| | - Grzegorz Korejwo
- Department of Nephrology, Gdańsk Medical University, Gdansk, Poland
| | - Marjolein Bonthuis
- ESPN/ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mathilde Lassalle
- Renal Epidemiology and Information Network Registry, Agence de la biomédecine, Saint-Denis La Plaine, France
| | | | - Viktorija Kuzema
- Department of Nephrology, Riga Stradins Clinical University Hospital, Riga, Latvia.,Department of Internal Medicine, Riga Stradins University, Riga, Latvia.,Latvian Nephrology Association, Riga, Latvia
| | | | | | - Anders Asberg
- Department of Transplantation Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | | | - Marc H Hemmelder
- Dutch Renal Registry, Nefrovisie Foundation, Utrecht, The Netherlands
| | | | - Evgueniy Vazelov
- Dialysis Clinic, "Alexandrovska" University Hospital, Sofia Medical University, Sofia, Bulgaria
| | - Anton Andrusev
- Chronic Dialysis, Russia & CIS Medical Department, Company "Baxter" AO, Moscow, Russia.,Renal Replacement Registry, Russian Dialysis Society, Moscow, Russia
| | - Pablo Castro de la Nuez
- Information System of the Autonomic Transplant Coordination of Andalucia (SICATA), Seville, Andalucia, Spain
| | - Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kirill Komissarov
- Minsk Scientific and Practical Center of Surgery, Transplantation and Hematology, Minsk, Belarus
| | | | - Ángela Magaz
- Unidad de Información de Pacientes Renales - UNIPAR, Basque Country, Spain
| | - Carmen Santiuste de Pablos
- Murcia Renal Registry, Department of Epidemiology, Murcia Regional Health Authority, IMIB-Arrixaca, Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ivan Bubić
- Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Clinical Sciences I, Faculty of Health Sciences, University of Rijeka, Rijeka, Croatia
| | - Jamie P Traynor
- Scottish Renal Registry, Meridian Court, ISD Scotland, Glasgow, UK
| | - Kyriakos Ioannou
- Cyprus Renal Registry, Nicosia, Cyprus.,Nephrology Department, American Medical Center, Nicosia, Cyprus
| | - Alma Idrizi
- Service of Nephrology, UHC "Mother Teresa", Tirana, Albania
| | - Runolfur Palsson
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Viera Spustova
- Department of Clinical and Experimental Pharmacotherapy, Slovak Medical University, Bratislava, Slovakia
| | | | - Faical Jarraya
- Service de Néphrologie, Faculte de medicine, CHU H Chaker Sfax and LR19ES11, Sfax, Tunisia
| | - Maurizio Nordio
- Division of Nephrology, Dialysis and Transplantation, AULSS2 Treviso, Italy
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Kaunas, Lithuania.,Nephrology Department, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018, Team 5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Kramer A, Pippias M, Noordzij M, Stel VS, Andrusev AM, Aparicio-Madre MI, Arribas Monzón FE, Åsberg A, Barbullushi M, Beltrán P, Bonthuis M, Caskey FJ, Castro de la Nuez P, Cernevskis H, De Meester J, Finne P, Golan E, Heaf JG, Hemmelder MH, Ioannou K, Kantaria N, Komissarov K, Korejwo G, Kramar R, Lassalle M, Lopot F, Macário F, Mackinnon B, Pálsson R, Pechter Ü, Piñera VC, Santiuste de Pablos C, Segarra-Medrano A, Seyahi N, Slon Roblero MF, Stojceva-Taneva O, Vazelov E, Winzeler R, Ziginskiene E, Massy Z, Jager KJ. The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016: a summary. Clin Kidney J 2019; 12:702-720. [PMID: 31583095 PMCID: PMC6768305 DOI: 10.1093/ckj/sfz011] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Indexed: 11/30/2022] Open
Abstract
Background This article summarizes the ERA-EDTA Registry’s 2016 Annual Report, by describing the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2016 within 36 countries. Methods In 2017 and 2018, the ERA-EDTA Registry received data on patients undergoing RRT for ESRD in 2016 from 52 national or regional renal registries. In all, 32 registries provided individual patient data and 20 provided aggregated data. The incidence and prevalence of RRT and the survival probabilities of these patients were determined. Results In 2016, the incidence of RRT for ESRD was 121 per million population (pmp), ranging from 29 pmp in Ukraine to 251 pmp in Greece. Almost two-thirds of patients were men, over half were aged ≥65 years and almost a quarter had diabetes mellitus as their primary renal diagnosis. Treatment modality at the start of RRT was haemodialysis for 84% of patients. On 31 December 2016, the prevalence of RRT was 823 pmp, ranging from 188 pmp in Ukraine to 1906 pmp in Portugal. In 2016, the transplant rate was 32 pmp, varying from 3 pmp in Ukraine to 94 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2007–11, the 5-year unadjusted patient survival probability on all RRT modalities combined was 50.5%. For 2016, the incidence and prevalence of RRT were higher among men (187 and 1381 pmp) than women (101 and 827 pmp), and men had a higher rate of kidney transplantation (59 pmp) compared with women (33 pmp). For patients starting dialysis and for patients receiving a kidney transplant during 2007–11, the adjusted patient survival probabilities appeared to be higher for women than for men.
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Affiliation(s)
- Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maria Pippias
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anton M Andrusev
- State-financed health institution, City Clinical Hospital #52 of Moscow City Health Department, Moscow, Russia
| | | | | | - Anders Åsberg
- Department of Transplantation Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | | | | | - Marjolein Bonthuis
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,ESPN/ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Fergus J Caskey
- UK Renal Registry, Southmead Hospital, Bristol, UK.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Pablo Castro de la Nuez
- Information System of the Autonomic Transplant Coordination of Andalucia (SICATA), Seville, Andalucia, Spain
| | - Harijs Cernevskis
- Department of Internal Medicine, Riga Stradins University, Riga, Latvia
| | - Johan De Meester
- Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium
| | - Patrik Finne
- Finnish Registry for Kidney Diseases, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Eliezer Golan
- Israel Renal Registry-ISNH, Hemodialysis Unit, Meir Medical Center, Kfar-Saba, Israel
| | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Marc H Hemmelder
- Dutch Renal Registry Renine, Nefrovisie Foundation, Utrecht, The Netherlands
| | - Kyriakos Ioannou
- Nephrology Department, Apollonion Private Hospital, Nicosia, Cyprus.,Nephrology Department, American Medical Center, Nicosia, Cyprus
| | - Nino Kantaria
- Georgian Renal Registry, Dialysis, Nephrology, and Transplantation Union of Georgia, Tbilisi State Medical University, Tbilisi, Georgia
| | - Kirill Komissarov
- Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
| | - Grzegorz Korejwo
- Department of Nephrology, Gdańsk Medical University, Gdansk, Poland
| | | | - Mathilde Lassalle
- REIN Registry, Agence de la biomédecine, Saint-Denis La Plaine, France
| | - František Lopot
- Department of Medicine Prague, General University Hospital, Prague-Strahov, Czech Republic
| | - Fernando Macário
- Nephrology Department, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Bruce Mackinnon
- Scottish Renal Registry, Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Runólfur Pálsson
- Division of Nephrology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ülle Pechter
- Department of Internal Medicine, Tartu University, Tartu, Estonia
| | - Vicente C Piñera
- Servicio de Nefrología, Hospital Universitario Valdecilla, Santander, Spain
| | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, Spain
| | | | - Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpaşa, Istanbul, Turkey
| | | | | | - Evgueniy Vazelov
- Dialysis Clinic, "Alexandrovska" University Hospital, Sofia Medical University, Sofia, Bulgaria
| | - Rebecca Winzeler
- Institute of Nephrology, Stadtspital Waid Zurich, Zurich, Switzerland
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Kaunas, Lithuania.,Nephrology Department, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ziad Massy
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018 team5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Kawecka A, DȨbska-Ślizien A, Korejwo G, Prajs J, Król E, Rutkowski B, Lasek J, Gwoździewicz J. Evaluation of Gore-Tex Graft Patency in Hemodialysis Access. J Vasc Access 2018. [DOI: 10.1177/112972980300400203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim The purpose of this retrospective study was to analyze the patency and complications of Gore-Tex grafts used in hemodialysis (HD) access. Methods In the last 16 years, 1649 surgical procedures were performed on 655 patients to ensure and maintain permanent HD access. The study group consisted of 64 HD patients on whom 81 vascular synthetic PTFE Goretex grafts were performed. There were 28 males and 36 females, 3 of them were children (4.7%). Mean age was 54.2 years (range 15–77). Two types of Gore-Tex prosthesis were used: Diastat and Stretch. All grafts were implanted in the upper extremities. Kaplan-Meier survival curves were calculated to determine primary and secondary patency. Log-rank analysis was used to determine differences between curves. Results Primary and secondary patency at 12 months was 52.5% and 67.5%, and at 18 months respectively 41.5% and 58.2%. The Diastat graft had a lower primary and secondary patency compared with the Stretch graft (respectively p = 0.02 and p = 0.008). Factors such as gender, coexisting diabetes and hypertension did not determine graft patency. Thrombosis was one of the most frequent complications. The remaining complications included stenosis, pseudoaneurysms, infection, steal syndrome and seroma. Conclusion On the basis of our experience Stretch grafts appear a better option for creating vascular access for HD than Diastat grafts.
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Affiliation(s)
- A. Kawecka
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
| | - A. DȨbska-Ślizien
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - G. Korejwo
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Prajs
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
| | - E. Król
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - B. Rutkowski
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Lasek
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Gwoździewicz
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
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Rutkowski P, Tylicki L, Renke M, Korejwo G, Zdrojewski Z, Rutkowski B. Low-dose dual blockade of the renin-angiotensin system in patients with primary glomerulonephritis. Am J Kidney Dis 2004; 43:260-8. [PMID: 14750091 DOI: 10.1053/j.ajkd.2003.10.032] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Treatment with agents interfering with the renin-angiotensin system retards the progressive course of proteinuric chronic renal disease. However, because of unwanted effects associated with such therapy, some patients cannot be treated with these drugs at all or may be administered only very small doses. To find an optimal nephroprotective strategy for these patients, we compared antiproteinuric effects of combination therapy with an angiotensin-converting enzyme inhibitor and angiotensin II type 1 receptor antagonist in very small doses with treatment with either agent alone at greater, but not maximal, doses. We compared the concomitant use of benazepril, 5 mg, and losartan, 25 mg, and monotherapy with these agents in doses 2-fold greater. METHODS This is a randomized, open, crossover study of 3 treatments in 3 periods of 4 months each. Twenty-four patients with primary glomerulonephritis and nonnephrotic proteinuria, recognized previously as not able to be administered high doses of drugs from these classes, completed the protocol. RESULTS Combined therapy decreased 24-hour proteinuria (-45.54% versus baseline) more effectively than either losartan (-28.17%; analysis of variance, P < 0.01) or benazepril (-20.19%; analysis of variance, P < 0.001) alone. Subgroup analysis showed that antiproteinuric effects of combination therapy, as well as losartan or benazepril alone, were significantly greater in patients with basal proteinuria greater than 2 g/24 h than in those with proteinuria less than this value (P < 0.001, P < 0.01, and P < 0.05, respectively). All therapies significantly decreased blood pressure (BP) compared with baseline, but there were no differences between treatments in BP changes. CONCLUSION The study shows that combination therapy with very small doses of losartan and benazepril was more effective in reducing proteinuria than greater doses of either agent in monotherapy, and this greater antiproteinuric efficacy was independent of changes in BP.
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Affiliation(s)
- Przemyslaw Rutkowski
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
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Kawecka A, Korejwo G, Prajs J, Król E, Lasek J, Gwozdziewicz J. Evaluation of Gore-Tex graft patency in hemodialysis access. J Vasc Access 2003; 4:45-9. [PMID: 17642059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
AIM The purpose of this retrospective study was to analyze the patency and complications of Gore-Tex grafts used in hemodialysis (HD) access. METHODS In the last 16 years, 1649 surgical procedures were performed on 655 patients to ensure and maintain permanent HD access. The study group consisted of 64 HD patients on whom 81 vascular synthetic PTFE Gore-tex grafts were performed. There were 28 males and 36 females, 3 of them were children (4.7%). Mean age was 54.2 years (range 15-77). Two types of Gore-Tex prosthesis were used: Diastat and Stretch. All grafts were implanted in the upper extremities. Kaplan-Meier survival curves were calculated to determine primary and secondary patency. Log-rank analysis was used to determine differences between curves. RESULTS Primary and secondary patency at 12 months was 52.5% and 67.5%, and at 18 months respectively 41.5% and 58.2%. The Diastat graft had a lower primary and secondary patency compared with the Stretch graft (respectively p = 0.02 and p = 0.008). Factors such as gender, coexisting diabetes and hypertension did not determine graft patency. Thrombosis was one of the most frequent complications. The remaining complications included stenosis, pseudoaneurysms, infection, steal syndrome and seroma. CONCLUSION On the basis of our experience Stretch grafts appear a better option for creating vascular access for HD than Diastat grafts.
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Affiliation(s)
- A Kawecka
- Department of Trauma Surgery, Medical University of Gdansk, Gdansk - Poland
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6
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Affiliation(s)
- G Korejwo
- Department of Nephrology, Transplantology and Internal Medicine, Gdańsk Medical University, 7 Debinki St., 80-211 Gdańsk, Poland
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Słoniewski P, Korejwo G, Zieliński P, Moryś J, Krzyzanowski M. Measurements of the Obersteiner-Redlich zone of the vagus nerve and their possible clinical applications. Folia Morphol (Warsz) 1999; 58:37-41. [PMID: 10504781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The aim of our study was to describe anatomical variability of the root entry zone (REZ), also called the Obersteiner-Redlich zone, that represents the "junction zone" of glia and Schwann sheath of the cranial nerves. This zone has some clinical implications. The pulsatile compression of REZ by a vessel may produce clinical symptoms, such us trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia torticollis spasmodicus or even symptoms of essential hypertension when a vascular cross compression of REZ of a left vagus nerve is present. The vessel--cranial nerve contact in the skull base cysterns may be visualized in radiologic examinations, most accurately in magnetic resonance imaging. Because, we cannot distinguish the REZ from the rest of the vagus nerve in radiologic examinations we decided to measure the length of its REZ. The microanatomical study of the length of REZ zone of the vagus nerve was performed on 21 nerves taken from 17 human brain stems (12 men, 5 women, 14 left, 7 right), fixed with 8% buffered formalin solution. Paraffin embedded tissue was cut into 10-micron-thick sections parallel to the nerve longitudinal axis and stained with hematoxilin & eosin. Each of the nerves showed the presence of a zone of oligodendrocyte myelination, mean length 2 +/- 0.3 mm. In 17 nerves the transitional zone formed a cone-like process, in 4 nerves was shaped irregularly. The length of REZ (oligodendrocyte myelination plus "glial dome") had the mean length 3.5 +/- 0.9 mm.
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Affiliation(s)
- P Słoniewski
- Department of Neurosurgery, Medical University of Gdańsk
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