Hemodialysis Graft and Fistula Access and Intervention
The incidence of renal failure in children is 1–2/100,000 as compared to 30/100,000 in adults. Although the method of dialysis depends on many factors, in some European countries, hemodialysis is preferred in children older than 5 years with peritoneal dialysis used in younger children and those less than 10 kg in weight. The National Kidney Foundation (NKF) has developed the Kidney Dialysis Outcomes Quality Initiative (K/DOQI) guidelines that serve as the standards of hemodialysis access management. Methods of dialysis access that are used in patients requiring hemodialysis include hemodialysis catheters, arteriovenous grafts (AVGs), and arteriovenous fistulae (AVFs). One of the current goals of the DOQI guidelines is to have an AVF placed in at least 50 % of patients with new onset renal failure and in at least 40 % of patients requiring hemodialysis. The DOQI guidelines also recommend that catheters should be used in less than 10 % of patients requiring hemodialysis. This chapter will focus on the management of dysfunctional AVGs and AVFs.
KeywordsVenous Outflow Cephalic Vein Kidney Disease Outcome Quality Initiative Arterial Anastomosis Hemodialysis Access
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