Resolved: Fistulas are preferred to grafts as initial vascular access for dialysis. Con.
نویسندگان
چکیده
There is growing concern that the Fistula First Initiative, KDOQI guidelines, and subsequent pressure from the Centers for Medicare and Medicaid Services lack reasonableness regarding likely success for fistula maturation in a heterogeneous, new-onset dialysis population. Here the various positions are examined from multiple perspectives.
منابع مشابه
بررسی میزان کارایی و عوارض گرافت صناعی عروقی پلی تترا فلورو اتیلن در بیماران همودیالیزی
Background: Dialysis access procedures and complications are important causes of morbidity and hospitalization for chronic hemodialysis patients. Ideally, any patient undergoing hemodialysis should receive an autogenous fistula that can be accessed throughout the patient's life. In patients with primarily unsuitable or secondarily surgically-exhausted veins, a prosthetic graft can be performed....
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Although arteriovenous fistulas are considered superior to grafts, it is unknown whether that is true in the subset of patients with a previous failed fistula. For investigation of this question, a prospective vascular access database was queried retrospectively to compare the outcomes of 59 fistulas and 51 grafts that were placed in the upper arm after primary failure of an initial forearm fis...
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Over a seven year period from 1982 to 1989,3337 conduits were created in 3137 patients with end stage renal disease (ESRD) as access for chronic dialysis. These included 2690 side-to-side arteriovenous fistulae (A VF), 168 end-to-side A VFs, 10 autogenous vein grafts, 51 homogenous frozen vein grafts, 109 polytetrafluoroethylene (PTFE) grafts, 209 emergency external arteriovenous shunts, t...
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Optimizing vascular access outcomes remains an ongoing challenge for clinical nephrologists. All other things being equal, fistulas are preferred over grafts, and grafts are preferred over catheters. Mature fistulas have better longevity and require fewer interventions, as compared with mature grafts. The major hurdle to increasing fistula use is the high rate of failure to mature of newly crea...
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Central venous catheters in nephrology were originally introduced to provide temporary vascular access for shortterm dialysis and were never meant to play a part in the dialysis patients’ long term care. Currently, tunneled, cuffed, doublelumen silastic catheters are used for permanent vascular access in many patients, particularly those with limited alternative options for vascular access and ...
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ورودعنوان ژورنال:
- Journal of the American Society of Nephrology : JASN
دوره 19 9 شماره
صفحات -
تاریخ انتشار 2008