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Nephrol Dial Transplant (2001) 16: 1542-1545
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Vascular access: care and monitoring of function

R. Vanholder

Nephrology Unit, Department of Internal Medicine, University Hospital, Gent, Belgium

Keywords: haemodialysis; native arterio-venous fistula; polytetrafluoroethylene graft; thrombosis; vascular access

Introduction

Without an adequate vascular access, haemodialysis efficiency is reduced, which results in increased morbidity and mortality [1]. Once the last access possibility has been exhausted, the patient is faced with a life-threatening condition. Access-related problems are responsible for ~50% of the hospitalizations of haemodialysis patients [2]. Hence, the quality of vascular access is not only a medical but also a socio-economic issue.

From the moment that the first access is created, an ongoing process is often started that will end with the loss of all access possibilities if the patient survives long enough. A careful approach will postpone this moment and will help to sustain life and quality of life longer than if access systems are constructed and monitored carelessly. The ideal access should provide adequate blood flow for an indefinite time, so that dialysis delivery is maximized upon each cannulation. Complica tions such as thrombosis, . . . [Full Text of this Article]

The native arterio-venous fistula

Early measures and timely referral

Synthetic grafts for vascular access

Vascular access thrombosis and infection

Early detection of failing vascular access

Therapeutic strategies

Conclusion

Notes

References


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