Acesso vascular para hemodiálise: avaliação do tipo e local anatômico em 23 unidades de diálise distribuídas em sete estados brasileiros

• Autor(a) principal: Linardi, Fábio
• Data de Publicação: 2003
• Outros Autores: Linardi, Felipe De Francisco, Bevilacqua, José Luís, Morad, José Francisco Moron, Costa, José Augusto, Miranda Júnior, Fausto [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000k33f
• Texto Completo: http://dx.doi.org/10.1590/S0100-69912003000300005; http://repositorio.unifesp.br/handle/11600/1740
• topic: Renal dialysis; Hemodialysis units, hospital; Arteriovenous fistula; Catheters indwelling; Catheter; Kidney failure, chronic; Hemodiálise; Fístula arteriovenosa; Acesso vascular; Cateter; Insuficiência renal crônica

BACKGROUND: To demonstrate type and local of vascular access for hemodialysis used in 23 dialysis centers in seven Brazilian states. METHODS: From October 1999 to August 2000, a total of 2559 patients in 23 hemodialysis centers were studied to determine: A- the frequency of catheter utilization and arteriovenous fistulae (AVF) as a vascular access for hemodialysis .B- the types of catheters (cuffed, tunneled catheters) or acute one and the sites of choice for the insertion. C- if AVF was the access, its type (native or with insertion of polytetrafluoroethylene - PTFE) and location (distal or proximal). D- the costs with vascular access as a percentage of the total costs of the unit. RESULTS: The study showed that 93.4% of the patients had an AVF as a vascular access for hemodialysis and the remaining 6.6% had a catheter. Distal native AVF was the more frequently constructed (74.8%), while the proximal native AVF was constructed in 21.7% of the times. Insertion of PTFE reached 3.2%, saphenous vein was used in 0.1% and the others AVFs, 0.2%. Cuffed, tunneled catheters (long term catheters) were used in 8.7% and acute catheters in 91.3%. The sites of choice when using an acute catheter were the subclavian and internal jugular veins (both with 42.4% of the preference) and the femoral vein in 6.5%. The costs with a vascular access for hemodialysis reached 1% of the total costs of the unit. CONCLUSIONS: Vascular access for hemodialysis in Brazil has different aspects compared with United States of America or European data. The most frequently vascular access constructed is the distal native AVF and the use of PTFE for AVF construction is very low.