Dialysis Access Intervention
End-stage renal disease (ESRD) affects over half a million Americans and the prevalence is increasing as the population ages. Hospitalizations for dialysis access and its associated problems cost over a billion dollars per year. Dialysis access is the lifeline for patients with ESRD, yet durable long-term outcomes are difficult to achieve.
KeywordsObesity Migration Toxicity Catheter Urea
- 1.2009 Annual Report United States Renal Data System. Available at http://www.usrds.org/adr.htm. Æ This is a national site to find comprehensive data including incidence, demographics, and cost.
- 2.KDOQI™ Guidelines and Commentaries. Available at http://www.kidney.org/professionals/kdoqi/guidelines_commentaries.cfm. Æ This is a comprehensive the national evidence-based clinical practice guidelines and standard of care.
- 3.Voormolen EH, Jahrome AK, Bartels LW, Moll FL, Mali WP, Blankestijn PJ. Nonmaturation of arm arteriovenous fistulas for hemodialysis access: A systematic review of risk factors and results of early treatment. J Vasc Surg. 2009 May;49(5):1325–36. Review. PMID: 19394557. Æ This review of 33 studies conclusively shows that many non matured AVFs can be salvaged although techniques vary. Google Scholar
- 4.Haage P, Günther RW. Radiological intervention to maintain vascular access. Eur J Vasc Endovasc Surg. 2006 Jul;32(1):84–9. Epub 2005 Nov 16. Review. PMID: 16297644 renal angiography at the time of cardiac catheterization. Æ A comprehensive review from Germany author presenting common dialysis problems and suitable approaches to treating them. Google Scholar
- 5.Gelbfish GA. Surgical versus percutaneous care of arteriovenous access. Semin Vasc Surg. 2007 Sep;20(3):167–74. Review.PMID: 17884618. Æ This is an expert opinion piece that provides an excellent overview of dialysis access problems and how to approach them. Google Scholar
- 6.Haskal ZJ, Trerotola S, Dolmatch B, Schuman E, Altman S, Mietling S, Berman S, McLennan G, Trimmer C, Ross J, Vesely T. Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med. 2010 Feb 11;362(6):494–503.PMID: 20147715. Æ The trial is the first of its kind as it is a randomized trial of 190 patients, suggesting stent grafts may be superior to simple balloon angioplasty in treating AVG stenoses. PubMedCrossRefGoogle Scholar