Basic Steps for Increasing the Rate of Autogenic Vascular Accesses for Hemodialysis

:  The number of patients on chronic hemodialysis (HD) is steadily increasing worldwide. The creation of a well‐functioning vascular access represents a critical aspect in their management. Autogenous arteriovenous fistulas (AVF) are considered the first choice vascular access in terms of lower morb...

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Bibliographic Details
Published in:Therapeutic apheresis and dialysis 2003-04, Vol.7 (2), p.238-243
Main Author: Salgado, Octavio J.
Format: Article
Language:English
Subjects:
Arteriovenous fistula
Arteriovenous Shunt, Surgical - adverse effects
Arteriovenous Shunt, Surgical - methods
Fistula maturation
Fistula monitoring
Graft placement
Hemodialysis
Humans
Patient Education as Topic
Postoperative Complications
Renal Dialysis - methods
Salvage procedures
Time Factors
Vascular Patency
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Summary::  The number of patients on chronic hemodialysis (HD) is steadily increasing worldwide. The creation of a well‐functioning vascular access represents a critical aspect in their management. Autogenous arteriovenous fistulas (AVF) are considered the first choice vascular access in terms of lower morbidity and costs, and higher survival rates when compared with grafts. However, creating AVF at high rates is a complex task that requires a multidisciplinary approach, which includes nephrologists, access surgeons, dialysis nurses and radiologists. In the present work we review concisely the basic steps, for preserving all potential autogenic sites at both upper extremities for future AVF creation and, for prolonging the length of AVF survival. We feel that a more proactive involvement of nephrologists in the basic steps for AVF creation would substantially contribute to increase AVF rates among HD patients.
ISSN:1744-9979
1744-9987
DOI:10.1046/j.1526-0968.2003.00037.x