I have a copy of another article by Dr. Saad and Dr. Vesely that was in JVIR in October of 2004. It too discusses Venous Access for Patients with Kidney disease.
It also discusses the calculation for the GFR. Fortunately, our institution includes this already calculated as part of our chem screen. I would hate to have to do that calculation! (And yes, most of us realize that other factors can effect Creatinine levels.) If he has any other articles about this I would like to look them up if you don't mind sharing them. I like sharing this info with our nephrologists. It supports what we all our triing to do.
Thanks,
Julie
"Hamblin, Richelle" <[EMAIL PROTECTED]> wrote:
Dr Saad is a physician at our hospital, and he is a Nephrologist. Any patient that has a creatinine of 1.9 or greater is closely reviewed before placing a PICC. If a line is needed and there is no potential for dialysis in the next year we will place a PICC (elevated creatinine is not directly related to kidney failure). If the patient is having any kidney failure VIR places a tunneled line in the jugular. I was recently reading some information from the NKF and if I remember correctly a normal creatinine should be 1.2 for women and 1.4 for men. It is also stated that GFR is a better indicator than creatinine when determining kidney failure. This needs to be calculated for every patient and there is a link that helps with the calculation on their web site. I also have two articles written by Dr. Saad. I have a great deal of respect for him and his quest to keep peripheral veins from being damaged by any peripherally inserted device.-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway
Sent: Wednesday, September 20, 2006 11:16 AM
To: Erickson, Wendy; [EMAIL PROTECTED]
Subject: Re: Potential Dialysis Patients and PICCsThis comes directly from the Dialysis Outcome Quality Initiative (DOQI guidelines) from the National Kidney Foundation - www.nkf.org I think. LynnAt 6:51 AM -0500 9/20/06, Erickson, Wendy wrote:Last week at the AVA conference we heard a speaker indicate that a contraindication for a PICC is a patient with a creatinine greater than 3. Our docs have asked us to avoid the non-dominant arm for PICCs - which sometimes requires a crystal ball, as to who might end up on dialysis. Having something more concrete like the creatinine level would be much better for us. Is there any reference or study out there that backs this up? I know I will need ammunition when I approach the nephrologists and surgeons, beyond "I heard it at a conference"!Thanks in advance!Wendy Erickson RN
PICC Service Coordinator
Luther Midelfort - Mayo Health System
Eau Claire WI********************Confidentiality Notice********************
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