Dialysis Access


Introduction

  • 1.

    In the first quarter of 2014, 671,851 patients were treated for end-stage renal disease (ESRD).

  • 2.

    In 2013, the number of people on the kidney transplant list was 5 times greater than the number of people who received a transplant.

  • 3.

    2006 National Kidney Disease Outcomes Quality Initiative (K/DOQI)

    • a.

      An initiative that set a goal of arteriovenous (AV) fistula target rate greater than 65% with catheter rate less than 10%

    • b.

      Due to fact that AV fistula has best long-term primary patency rates, has lowest rates of thrombosis, requires fewest secondary interventions, and has the lowest overall morbidity and mortality when compared with other modalities of dialysis access

  • 4.

    All patients on dialysis should be considered for kidney transplant and referred to a transplant program for evaluation, especially if dialysis access sites become limited.

General Overview of Dialysis Access Types

Short-Term/Emergent Access

  • 1.

    Can be used immediately for dialysis

    • a.

      Nontunneled (uncuffed catheters)

    • b.

      Tunneled (cuffed catheters)

    • c.

      Early cannulation grafts (e.g., Acuseal graft)

    • d.

      Peritoneal dialysis catheters

Long-Term Access

  • 2.

    Have to wait for maturation time before initiating dialysis

    • a.

      AV fistula

    • b.

      AV graft

    • c.

      HeRO graft

    • d.

      Peritoneal dialysis catheters

Dialysis Catheters

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here