Author/Editor		Malovrh, Marko
Title		Vascular access for hemodialysis: arteriovenous fistula
Type		članek
Source		Ther Apher Dial
Vol. and No.		Letnik 9, št. 3
Publication year		2005
Volume		str. 214-7
Language		eng
Abstract		The long-term survival and quality of life of patients on hemodialysis (HD) is dependant on the adequacy of dialysis via an appropriately placed vascular access. The optimal vascular access is unquestionably the autologous arteriovenous fistula (AVF), with the most common method being the conventional radio-cephalic fistula at the wrist. Recent clinical practice guidelines recommend the creation of native fistula or synthetic graft before the start of chronic HD therapy to prevent the need for complication-prone dialysis catheters. This could also have a beneficial effect on the rapidity of worsening kidney failure. A multidisciplinary approach (nephrologists, surgeons, radiologists and nurses) should improve the HD outcome by promoting the use of AVF. An important additional component of this program is the Doppler ultrasound for preoperative vascular mapping. Such an approach may be realized without unsuccessful surgical explorations, with a minimal early failure rate and a high maturation, even in patients with diabetes mellitus.
Descriptors		HEMODIALYSIS CATHETERS, INDWELLING ARTERIOVENOUS SHUNT, SURGICAL RADIAL ARTERY BRACHIAL ARTERY ULTRASONOGRAPHY, DOPPLER, DUPLEX