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Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis

The long-term survival and quality of life of patients on hemodialysis is dependant on the adequacy of dialysis via an appropriately placed vascular access. The native arteriovenous fistula (AV fistula) at the wrist is generally accepted as the vascular access of choice in hemodialysis patients due...

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Autor principal: Malovrh, Marko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: TheScientificWorldJOURNAL 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917211/
https://www.ncbi.nlm.nih.gov/pubmed/16845467
http://dx.doi.org/10.1100/tsw.2006.171
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author Malovrh, Marko
author_facet Malovrh, Marko
author_sort Malovrh, Marko
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description The long-term survival and quality of life of patients on hemodialysis is dependant on the adequacy of dialysis via an appropriately placed vascular access. The native arteriovenous fistula (AV fistula) at the wrist is generally accepted as the vascular access of choice in hemodialysis patients due to its low complication and high patency rates. It has been shown beyond doubt that an optimally functioning AV fistula is a good prognostic factor of patient morbidity and mortality in the dialysis phase. Recent clinical practice guidelines recommend the creation of a vascular access (native fistula or synthetic graft) before the start of chronic hemodialysis therapy to prevent the need for complication-prone dialysis catheters. A multidisciplinary approach, including nephrologists, surgeons, interventional radiologists, and nurses should improve the hemodialysis outcome by promoting the use of native AV fistulae. An important additional component of this program is the Doppler ultrasound for preoperative vascular mapping. This approach may be realized without unsuccessful surgical explorations, with a minimal early failure rate, and a high maturation, even in risk groups such as elderly and diabetic patients. Vascular access care is responsible for a significant proportion of health care costs in the first year of hemodialysis. These results also support clinical practice guidelines that recommend the preferential placement of a native fistula.
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spelling pubmed-59172112018-06-03 Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis Malovrh, Marko ScientificWorldJournal Review Article The long-term survival and quality of life of patients on hemodialysis is dependant on the adequacy of dialysis via an appropriately placed vascular access. The native arteriovenous fistula (AV fistula) at the wrist is generally accepted as the vascular access of choice in hemodialysis patients due to its low complication and high patency rates. It has been shown beyond doubt that an optimally functioning AV fistula is a good prognostic factor of patient morbidity and mortality in the dialysis phase. Recent clinical practice guidelines recommend the creation of a vascular access (native fistula or synthetic graft) before the start of chronic hemodialysis therapy to prevent the need for complication-prone dialysis catheters. A multidisciplinary approach, including nephrologists, surgeons, interventional radiologists, and nurses should improve the hemodialysis outcome by promoting the use of native AV fistulae. An important additional component of this program is the Doppler ultrasound for preoperative vascular mapping. This approach may be realized without unsuccessful surgical explorations, with a minimal early failure rate, and a high maturation, even in risk groups such as elderly and diabetic patients. Vascular access care is responsible for a significant proportion of health care costs in the first year of hemodialysis. These results also support clinical practice guidelines that recommend the preferential placement of a native fistula. TheScientificWorldJOURNAL 2006-07-14 /pmc/articles/PMC5917211/ /pubmed/16845467 http://dx.doi.org/10.1100/tsw.2006.171 Text en Copyright © 2006 Marko Malovrh. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Malovrh, Marko
Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis
title Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis
title_full Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis
title_fullStr Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis
title_full_unstemmed Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis
title_short Strategy for the Maximal Use of Native Arteriovenous Fistulae for Hemodialysis
title_sort strategy for the maximal use of native arteriovenous fistulae for hemodialysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917211/
https://www.ncbi.nlm.nih.gov/pubmed/16845467
http://dx.doi.org/10.1100/tsw.2006.171
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