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Vascular Access For Hemodialysis Therapy

  • A. S. Bode
  • J. H. M. Tordoir
Part of the Studies in Computational Intelligence book series (SCI, volume 404)

Abstract

Therapeutic options for patients suffering from end-stage renal disease have improved tremendously over the last decades and can be divided into three categories: hemodialysis, peritoneal dialysis and kidney transplantation. Transplantation remains the treatment of choice, however, lack of donor organs results in the necessity of performing-temporary dialysis therapies of which hemodialysis is carried out in the majority of patients.

To facilitate adequate hemodialysis therapy a reliable vascular access is mandatory and can be provided by either surgically connecting an artery with a vein (arteriovenous fistula), surgically connecting an artery with a vein using an interposition of prosthetic graft material (arteriovenous graft) or a central venous catheter. This chapter shortly reviews the condition of end-stage renal disease after which history of vascular access, different options to create a vascular access, pre-operative workup, surgical procedure, monitoring and usage, post-operative complications and the role of hemodynamics will be discussed. Finally, some future directions for vascular access creation and management will be identified.

Keywords

End-stage renal disease Vascular access Arteriovenous fistula Arteriovenous graft Central venous catheter Duplex ultrasonography Digital subtraction angiography Magnetic resonance angiography Cannulation Non-maturation Stenosis / Thrombosis Aneurysm Distal ischemia Cardiac failure Central venous obstruction Hemodynamics 

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© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Maastricht University Medical CenterMaastrichtThe Netherlands

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