New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?
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New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?
Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's...
متن کاملNew Insights into Dialysis Vascular Access: Introduction.
Optimizing vascular access outcomes continues to pose a tremendous challenge to nephrologists, surgeons, and radiologists who provide medical care to patients on hemodialysis. There is a huge discrepancy between the optimal vascular access outcome proposed by national guidelines (1) and the reality. Thus, for example, whereas the guidelines suggest that most patients should initiate hemodialysi...
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Failure of hemodialysis access is caused mostly by venous intimal hyperplasia, a fibro-muscular thickening of the vessel wall. The pathogenesis of venous neointimal hyperplasia in primary arteriovenous fistulae consists of processes that have been identified as upstream and downstream events. Upstream events are the initial events producing injury of the endothelial layer (surgical trauma, hemo...
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Hemodialysis remains the most commonly used RRT option around the world. Technological advances, superior access to care, and better quality of care have led to overall improvement in survival of patients on long-term hemodialysis. Maintaining a functioning upper extremity vascular access for a prolonged duration continues to remain a challenge for dialysis providers. Frequently encountered dif...
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A nephrologist is well equipped to understand and manage the complexities involved in educating and preparing a patient with chronic kidney disease to embrace the challenges involved with renal replacement therapy. The importance of vascular access in providing adequate dialysis therapy cannot be overemphasized. Unfortunately, it remains a weak link in providing optimal care and a major cause o...
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ژورنال
عنوان ژورنال: Clinical Journal of the American Society of Nephrology
سال: 2016
ISSN: 1555-9041,1555-905X
DOI: 10.2215/cjn.02190216