Arteriovenous fistula surveillance: everyones responsibility
Autor(a) principal: | |
---|---|
Data de Publicação: | 2012 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000400004 |
Resumo: | The arteriovenous fistula, as opposed to arteriovenous grafts and central venous dialysis catheters, remains the dialysis access of choice for haemodialysis patients, due to its superior long -term patency, low incidence of stenosis, thrombosis and infection. The basic tenant of vascular access monitoring and surveillance is that stenosis develops over a variable amount of time in a majority of arteriovenous fistula, and if detected and corrected, inadequate dialysis can be prevented, maturation can be facilitated and thrombosis and access loss can be avoided. Large randomised controlled trials are lacking to clearly identify the ideal surveillance strategies and benefits of surveillance, often only supported by observational studies and small single-centre randomised controlled trials. Fistula thrombosis is often used as an endpoint in trials looking at the beneficial effects of surveillance, although this occurs relatively infrequently in native arteriovenous fistula, and therefore other markers are required to define a dysfunctional fistula. Cost-effective ways to improve outcomes in these types of vascular accesses involves formalised training of staff and other healthcare professionals to better identify dysfunctional fistulas by physical examination, with the addition of surveillance studies to support these findings and pre -emptive intervention when stenosis is found. The costs invested in establishing multidisciplinary programmes to facilitate the care of these patients will likely reduce long-term resource utilisation in a growing population of dialysis patients worldwide. In this review, we examine the physiology of a dysfunctional fistula and evaluate available studies in the surveillance of arteriovenous fistulas. In addition, the importance of creating secondary arteriovenous fistula and how healthcare systems need to invest in improving the care of haemodialysis vascular access will be outlined |
id |
RCAP_618b9989ff44659bc5b70b9c3c838158 |
---|---|
oai_identifier_str |
oai:scielo:S0872-01692012000400004 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Arteriovenous fistula surveillance: everyones responsibilityArteriovenous fistuladysfunctional fistulahaemodialysismonitoringstenosissurveillanceThe arteriovenous fistula, as opposed to arteriovenous grafts and central venous dialysis catheters, remains the dialysis access of choice for haemodialysis patients, due to its superior long -term patency, low incidence of stenosis, thrombosis and infection. The basic tenant of vascular access monitoring and surveillance is that stenosis develops over a variable amount of time in a majority of arteriovenous fistula, and if detected and corrected, inadequate dialysis can be prevented, maturation can be facilitated and thrombosis and access loss can be avoided. Large randomised controlled trials are lacking to clearly identify the ideal surveillance strategies and benefits of surveillance, often only supported by observational studies and small single-centre randomised controlled trials. Fistula thrombosis is often used as an endpoint in trials looking at the beneficial effects of surveillance, although this occurs relatively infrequently in native arteriovenous fistula, and therefore other markers are required to define a dysfunctional fistula. Cost-effective ways to improve outcomes in these types of vascular accesses involves formalised training of staff and other healthcare professionals to better identify dysfunctional fistulas by physical examination, with the addition of surveillance studies to support these findings and pre -emptive intervention when stenosis is found. The costs invested in establishing multidisciplinary programmes to facilitate the care of these patients will likely reduce long-term resource utilisation in a growing population of dialysis patients worldwide. In this review, we examine the physiology of a dysfunctional fistula and evaluate available studies in the surveillance of arteriovenous fistulas. In addition, the importance of creating secondary arteriovenous fistula and how healthcare systems need to invest in improving the care of haemodialysis vascular access will be outlinedSociedade Portuguesa de Nefrologia2012-10-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000400004Portuguese Journal of Nephrology & Hypertension v.26 n.4 2012reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000400004Feddersen,Martin AnekRoger,Simon Davidinfo:eu-repo/semantics/openAccess2024-02-06T17:04:40Zoai:scielo:S0872-01692012000400004Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:18:49.477491Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Arteriovenous fistula surveillance: everyones responsibility |
title |
Arteriovenous fistula surveillance: everyones responsibility |
spellingShingle |
Arteriovenous fistula surveillance: everyones responsibility Feddersen,Martin Anek Arteriovenous fistula dysfunctional fistula haemodialysis monitoring stenosis surveillance |
title_short |
Arteriovenous fistula surveillance: everyones responsibility |
title_full |
Arteriovenous fistula surveillance: everyones responsibility |
title_fullStr |
Arteriovenous fistula surveillance: everyones responsibility |
title_full_unstemmed |
Arteriovenous fistula surveillance: everyones responsibility |
title_sort |
Arteriovenous fistula surveillance: everyones responsibility |
author |
Feddersen,Martin Anek |
author_facet |
Feddersen,Martin Anek Roger,Simon David |
author_role |
author |
author2 |
Roger,Simon David |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Feddersen,Martin Anek Roger,Simon David |
dc.subject.por.fl_str_mv |
Arteriovenous fistula dysfunctional fistula haemodialysis monitoring stenosis surveillance |
topic |
Arteriovenous fistula dysfunctional fistula haemodialysis monitoring stenosis surveillance |
description |
The arteriovenous fistula, as opposed to arteriovenous grafts and central venous dialysis catheters, remains the dialysis access of choice for haemodialysis patients, due to its superior long -term patency, low incidence of stenosis, thrombosis and infection. The basic tenant of vascular access monitoring and surveillance is that stenosis develops over a variable amount of time in a majority of arteriovenous fistula, and if detected and corrected, inadequate dialysis can be prevented, maturation can be facilitated and thrombosis and access loss can be avoided. Large randomised controlled trials are lacking to clearly identify the ideal surveillance strategies and benefits of surveillance, often only supported by observational studies and small single-centre randomised controlled trials. Fistula thrombosis is often used as an endpoint in trials looking at the beneficial effects of surveillance, although this occurs relatively infrequently in native arteriovenous fistula, and therefore other markers are required to define a dysfunctional fistula. Cost-effective ways to improve outcomes in these types of vascular accesses involves formalised training of staff and other healthcare professionals to better identify dysfunctional fistulas by physical examination, with the addition of surveillance studies to support these findings and pre -emptive intervention when stenosis is found. The costs invested in establishing multidisciplinary programmes to facilitate the care of these patients will likely reduce long-term resource utilisation in a growing population of dialysis patients worldwide. In this review, we examine the physiology of a dysfunctional fistula and evaluate available studies in the surveillance of arteriovenous fistulas. In addition, the importance of creating secondary arteriovenous fistula and how healthcare systems need to invest in improving the care of haemodialysis vascular access will be outlined |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-10-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000400004 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000400004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000400004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
dc.source.none.fl_str_mv |
Portuguese Journal of Nephrology & Hypertension v.26 n.4 2012 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799137278330667008 |