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Your search term(s) "vascular access" and "hemodialysis" returned 5 results.

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2005 CPMs Regarding Vascular Access Create Opportunities for Improving Care. Nephrology News & Issues. 21(12): 34-35. November 2007.

This article discusses the information from the 2005 Clinical Performance Measures (CPM) Project on vascular access. Vascular access is one of the clinical indicators reviewed each year as part of the CPM Project, which is produced by the End-Stage Renal Disease Networks. The sample for 2005 included about 9,000 randomly selected, in-center, hemodialysis patients who dialyzed during the last quarter of that calendar year. Data from 803 pediatric patients from that same time period are included. The three CPMs for vascular access measured the number of new patients dialyzing with an arteriovenous fistula (AVF), the number of continuing patients dialyzing with an AVF, the percentage of continuing patients dialyzing with a catheter continuously for 90 days or longer, and the percentage of patients whose grafts were routinely monitored for stenosis. In 2005, the data showed that 54 percent of new patients and 44 percent of continuing patients were dialyzed using an AVF, up from 27 percent and 30 percent, respectively, in 2000. The author notes that this is the extent of the positive news from the 2005 report. For example, catheter usage, known to be a major cause of morbidity, mortality, and increased end-stage renal disease (ESRD) expenditure, has not been reduced. Nearly three-quarters of all patients beginning hemodialysis in 2005 did so via a catheter, some 38 percent of these patients with catheters had no surgical access created or planned, and 65 percent of those patients preferred not to have surgery for access. The author reviews the data, discussing CPM goals, monitoring patients for stenosis, the situation with pediatric patients, and strategies to increase the use of AVF for vascular access for hemodialysis. Readers are referred to the complete 2005 Clinical Performance Measures Report, available at www.cms.hhs.gov/CPMProject. 1 reference.

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Kidney Failure Treatment Options: Making the Right Choice. Darling Point, New South Wales: Renal Resource Center. March 2007. 28p.

This booklet was written for people who have been diagnosed with kidney failure and who will need dialysis or a kidney transplant at some time in the future. Readers are encouraged to educate themselves about the different types of treatment for end-stage renal disease (ESRD) and to be active participants in their own health care decisions, along with their full health care team. The booklet includes five sections: when kidneys fail, which covers normal kidney function, chronic kidney disease (CKD), the symptoms of CKD, the different types of dialysis, and adjusting to dialysis; hemodialysis, including the details about how it works, the need for vascular access, home hemodialysis, medications, fluids, diet and exercise, pregnancy and contraception, employment, and holidays; peritoneal dialysis (PD), including the details about how it works, continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD), access for PD, PD at home, medications, fluids, diet and exercise, pregnancy and contraception, employment, and holidays; kidney transplantation, including the use of living donors, cadaveric donors, transplant success rates, what is involved in living donor kidney transplant, the long-term effects for living related or unrelated donors, preparing for a kidney transplant, patient selection, histocompatibility, the transplant waiting list, staying healthy before transplantation, the surgical techniques used, postoperative care and complications, and lifestyle issues; and management of kidney failure without dialysis, including declining dialysis treatment, withdrawing from dialysis treatment, and palliative care. Contact information is provided for some resource organizations in Australia. The booklet is illustrated with photographs of a variety of people in health care settings. The booklet is also available in Arabic, Chinese, Greek, Italian, and Vietnamese. 14 figures. 1 table.

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Vascular Access for Hemodialysis. Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse. 2007. 4 p.

When the kidneys fail, harmful wastes build up in the body, blood pressure may rise, and the body may retain excess fluid and not make enough red blood cells. When this happens, treatment is required to replace the work of the failed kidneys. Hemodialysis is the most common method used to treat advanced and permanent kidney failure. This fact sheet helps readers recently diagnosed with kidney failure understand the vascular access that is required for hemodialysis. Topics include the need for establishing vascular access a few weeks or months before dialysis is started, the arteriovenous fistula, the arteriovenous graft, a venous catheter that is used for temporary access, what to expect during hemodialysis, possible complications that may be encountered, and how to take care of the vascular access. Additional sections describe some of the research projects currently underway in this area, as well as the availability of a patient education series titled the NIDDK Kidney Failure Series. The brochure concludes with the contact information for the National Kidney Foundation (www.kidney.org) and a brief description of the activities of the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 3 figures.

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Vascular Access for Hemodialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 27-46.

Successful hemodialysis requires access to large blood vessels capable of supporting rapid extracorporeal blood flow. This chapter on vascular access (VA) for hemodialysis is from a textbook on the clinical care of dialysis patients. There are three general situations in which hemodialysis is required: acute renal failure, poisonings, and end stage renal disease (ESRD). In the first two situations, immediate and perhaps only temporary access to the circulation system is required. These requirements are best met by the percutaneous insertion of dual-lumen hemodialysis catheters into large central veins. In ESRD, reliable, long-term access to the circulation system is essential for adequate dialysis therapy. Long-term access is best accomplished by the construction of an endogenous arteriovenous fistula. The authors discuss patient care management, surgical techniques, and the complications of VA, which can include thrombosis, infection of native and synthetic fistulas, cuffed catheter-related infection, problems with antibiotics, congestive heart failure, hand ischemia, aneurysms and pseudoaneurysms, and venous stenoses. The authors conclude that the morbidity of a maintenance hemodialysis patient is in large part determined by the ability of the nephrologists, vascular surgeon, and vascular radiologist to establish and maintain adequate vascular access. 7 figures. 143 references.

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Your Access: A Choice for a Better Life. In Control. 1(1): P1, P4. March 2004.

This newsletter article helps readers understand the role of the vascular access in hemodialysis. The article explains the different types of vascular access (VA), including fistulas, grafts, and catheters, noting that the fistula is the best type of VA, resulting in longest life and fewest complications. A fistula is made by linking two blood vessels: a fast-flowing artery and an easy-to-reach vein. Fistulas are less prone to infections and blood clots than either grafts or catheters. A checklist of strategies for preparing to get a fistula is included. Patients are advised to plan for ongoing treatment changes, which may happen when a fistula or other VA fails. The article concludes with a list of recommended resources for readers wanting more information and a quiz for readers to self-test their knowledge about fistulas. 1 figure. 4 references.

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