Fri, May 26, 2017 | updated 10:21 PM IST

How to revive a Fistula , advice to kidney patients undergoing dialysis

Updated: Jul 26, 2016 08:28 IST      
How to revive a Fistula , advice to kidney patients undergoing dialysis

By Dr. Virender Sheorain

Gurgaon , July 26, (ANI): For those who have suffered a kidney failure, dialysis provides a new lease of life. During dialysis, the blood from a patient's body is taken to a machine, cleaned and returned. The machine functions as an artificial kidney and the process of dialysis generally takes about four hours. .

The most popular way of doing dialysis is through the AV Fistula, where an artery, particularly in the forearm, is connected to a vein. After the fistula is created, the patient goes through hemo-dialysis, where the blood is removed from the body through a needle and returned through another needle after cleaning. In other words, the Fistula functions as a life-line for patients.

The dialysis has to ensure that the amount of blood cleaned during the hemo-dialysis is up to the required volume. To enable this, the vascular access should allow continuous high volumes of blood flow. There are occasions when the Fistula may fail to do so. To prevent this, one has to take proper care of the Fistula. .

How to ensure that this does not happen? Or, what steps can one take when it does happen. Firstly, as soon as a Fistula is made, the patient should be advised to visit the vascular/interventional radiology department of the hospital to have a check. This is done through Ultrasound Doppler to examine how the Fistula is functioning and maturing.

Patients should also go for a regular check of the Fistula by Doppler when they are on maintenance hemo-dialysis Pre- and post-operative evaluation of the upper extremity veins and arteries with duplex ultrasound is an useful adjunct to physical examination to help the Fistula to keep functioning efficiently.

The role that duplex ultrasound plays as part of a surveillance programme is very valuable, as this modality allows identification and localization of abnormalities which may potentially threaten access function and patency. Identification and correction of access abnormalities at early stages definitely improves longevity and function of the Fistula.

Understanding the information gained through Doppler evaluation is a complex problem. It should be performed by an expert who generally treats the problem. Timely action by an endovascular specialist would help in saving the Fistula.

Endovascular non-surgical treatment-a form of minimally invasive surgery which accesses many regions of the body via major blood vessels, when a endovascular specialist introduces a catheter percutaneously into a large blood vessel -- helps in saving the failing Fistula. It can be performed through percutaneous non-surgical procedures like Fistulogram, Fistuloplasty, stenting and thrombolysis.

A'failing Fistula' can be revived through these procedures.

Failing Fistula normally has the following symptoms i) Difficulty in placing needles during dialysis; . ii) Thrombus or clot aspiration during dialysis; iii) Elevated venous pressure, greater than 200 mm.Hg on a 3q00 cc/min pump. iv) Elevated re-circulation time of 15% or greater; v. Low urea reduction rate of less than 60%; vi Collapse of the Fistula suggesting poor arterial inflow; vii) Poorly matured Fistula; viii)Loss of thrill; ix) Distal limb pain and x) Swelling around the fistula. Narrowing may occur at any sites along the length of the fistula.

Doppler surveillance and endovascular salvage of the fistula is practiced routinely in Western countries, but it is still in its formative stage in India. A kidney patient needs to be aware of the problems and the solutions, which are available in the country. (ANI)

Dr Virender Sheorain, has undergone training in vascular- endovascular procedures, and has established such service in Medanta Medicity Hospital in Gurgaon.(ANI)

Here's how hand amputation, reattachment affect brain

Updated: May 26, 2017 08:20 IST     

Washington D.C. [USA], May 26 (ANI): When a person loses a hand to amputation, nerves that control sensation and movement are severed, causing dramatic changes in areas of the brain that controlled these functions. As a result, areas of the brain devoted to the missing hand take on other functions.

Full Story >>

Soon, toy cars that'll help get kids with disabilities moving

Updated: May 26, 2017 08:19 IST     

Washington D.C. [USA], May 26 (ANI): Two new modified toy car designs have been developed for children with disabilities in an effort to encourage them to further explore, play, and engage in physical and social activities.

Full Story >>

Being 'cruel to be kind' really works!

Updated: May 25, 2017 07:29 IST     

Washington D.C. [USA], May 25 (ANI): Can making people feel bad really help them? Yes, according to a recent study.

Full Story >>

DNA may have only modest impact on sexual assault arrests

Updated: May 24, 2017 19:06 IST     

Washington D.C. [USA], May 24 (ANI): Most arrests in sexual assault cases occur before crime laboratory results are available, a new study found, suggesting that DNA testing may influence arrests in just a small number of cases.

Full Story >>

Your eyes can reveal if you have the post-disaster blues

Updated: May 24, 2017 16:01 IST     

Washington D.C. [USA], May 24 (ANI): Turns out, your eyes really are the windows to your soul as a recent study has found that depression risk following a natural disaster can be predicted via pupil dilation.

Full Story >>

Size of whale has evolved in the recent past!

Updated: May 24, 2017 11:03 IST     

New Delhi [India], May 7 (ANI): Interestingly, blue whales, the largest vertebrate animal that ever lived, have recently evolved into giants.

Full Story >>

Washington D.C. [USA], May 7 (ANI): A team of researchers discovered that deep portions of earth's mantle might be as hot as it was more than 2.5 billion years ago.

Full Story >>

Death by Kissing Bugs more common than thought: Study

Updated: May 22, 2017 13:26 IST     

New York [USA], May 22 (ANI): Kissing Bugs, who like to bite humans around their lips and faces, as they sleep, are more dangerous than you have ever thought of.

Full Story >>

Now, deaf-blind can 'watch' television with this technology

Updated: May 21, 2017 14:15 IST     

Washington D.C. [USA], May 21 (ANI): In a first, researchers have developed a new technology that types Braille or subtitles of television channels in real time and helps deaf-blind people "watch" television without intermediaries.

Full Story >>

Planting trees cannot replace cutting CO2 emissions!

Updated: May 18, 2017 17:15 IST     

New Delhi [INDIA], May 18 (ANI): According to a new study, growing plants and then storing CO2, taken up from the atmosphere, is no viable option to counteract unmitigated emissions from fossil fuel burning.

Full Story >>

Washington D.C. [USA], May 17 (ANI): Large families and strong social ties may help female rhesus macaques live longer, by reducing their chances of dying by 2.3 percent in one year, reveals a new study.

Full Story >>

Turns out, 'drunk you' not that different from 'sober you'

Updated: May 16, 2017 07:21 IST     

Washington D.C. [USA], May 16 (ANI): Your personality may change when you drink, but less than you think, according to a recent study.

Full Story >>

Researchers find ways to make solar energy affordable

Updated: May 14, 2017 21:20 IST     

Washington D.C. [USA], May 14 (ANI): In a recent study, researchers used data science to determine and predict the effects of exposure to weather and other conditions on materials in solar panels.

Full Story >>

Washington D.C. [USA], May 14 (ANI): Just like students choose their flatmates, Briton researchers have found that males of great tit birds are quiet selective when it comes to neighbourhood and opt to nest together with like-minded neighbours to improve their chances of survival.

Full Story >>

Washington D.C. [USA], May 13 (ANI): A group of international scientists studying China's Yellow River has come up with an analytic formula that could help officials better predict and prevent its all-too-frequent floods, which threaten as many as 80 million people.

Full Story >>

'Winged' snakes once slithered the Earth

Updated: May 13, 2017 12:54 IST     

Washington D.C. [USA], May 13 (ANI): A mysterious 5-million-year-old "winged serpent" has finally been identified as a new species of ancient snakes.

Full Story >>

Newly-found distant 'warm Neptune' has primitive atmosphere

Updated: May 12, 2017 10:33 IST     

Washington D.C. [USA], May 12 (ANI): A team of scientists has discovered a distant Neptune-sized planet that has clear skies and an atmosphere almost entirely composed of hydrogen and helium, scientists have discovered.

Full Story >>

New 3-D printed 'bionic skin' lets robots 'feel'

Updated: May 11, 2017 12:27 IST     

Washington D.C. [USA], May 11 (ANI): A team of researchers has come up with a revolutionary process for 3D printing stretchable electronic sensory devices that could give robots the ability to feel their environment.

Full Story >>

Washington D.C. [USA], May 11 (ANI): African lion is the next big cat species to become extinct as they have lost most of their prey, according to a recent study.

Full Story >>

The hidden cost of helping your co-workers

Updated: May 10, 2017 19:56 IST     

Washington D.C. [USA], May 10 (ANI): If you're a co-worker who helps other, you are likely to feel good, but are those good feelings coming at a price?

Full Story >>