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Optimal timing for vascular access creation.
- Source :
-
The journal of vascular access [J Vasc Access] 2017 Mar 06; Vol. 18 (Suppl. 1), pp. 29-33. Date of Electronic Publication: 2017 Mar 05. - Publication Year :
- 2017
-
Abstract
- Many guidelines recommend that end-stage renal disease (ESRD) patients should have a permanent vascular access, preferably an autologous arteriovenous fistula (AVF), at the start of renal replacement therapy. Nevertheless, a large proportion of patients still start hemodialysis with a central venous catheter (CVC). On the other hand, there are increasing numbers of patients in whom an AVF has been created, but who never actually end up on dialysis, as well as a substantial number of patients in whom creation of a vascular access has been attempted unsuccessfully.To improve this situation, timely exploration to assess suitability for and creation of preemptive AVF should be promoted. Decision to construct an AVF should depend on the likelihood and rate of progression to ESRD. For this goal, some reliable prediction models are available. Also, the likelihood that such an attempt will result in a successful outcome should be taken into account, but suitable validated models to accurately make such estimates are lacking. Next to patient-specific factors, some local conditions such as easy access to a vascular surgeon should also be incorporated in the decision-making process between the nephrology team and the patient.
- Subjects :
- Catheterization
Clinical Decision-Making
Decision Support Techniques
Disease Progression
Humans
Kidney Failure, Chronic diagnosis
Kidney Failure, Chronic physiopathology
Patient Selection
Practice Guidelines as Topic
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Arteriovenous Shunt, Surgical adverse effects
Arteriovenous Shunt, Surgical standards
Kidney Failure, Chronic therapy
Renal Dialysis standards
Time-to-Treatment
Subjects
Details
- Language :
- English
- ISSN :
- 1724-6032
- Volume :
- 18
- Issue :
- Suppl. 1
- Database :
- MEDLINE
- Journal :
- The journal of vascular access
- Publication Type :
- Academic Journal
- Accession number :
- 28297054
- Full Text :
- https://doi.org/10.5301/jva.5000685