Rohan Arasu1, Dev Jegatheesan2, Yogeesan Sivakumaran3. 1. Registrar in the Department of Vascular Surgery at Fiona Stanley Hospital and Associate Lecturer in the Faculty of Medicine at the University of Queensland in Brisbane, Australia. 2. Nephrologist in the Department of Nephrology at Princess Alexandra Hospital and Lecturer in the Centre for Kidney Disease Research at the University of Queensland. 3. Vascular surgeon in the Department of Vascular Surgery at Princess Alexandra Hospital and Senior Lecturer in the School of Clinical Medicine at the University of Queensland.
Abstract
OBJECTIVE: To provide family physicians with an evidence-based overview on the various methods of vascular access for hemodialysis (HD) and to provide a framework for the clinical assessment of HD access. SOURCES OF INFORMATION: A MEDLINE literature search was conducted using the MeSH terms arteriovenous fistula, arteriovenous graft, central venous catheter, and hemodialysis (or haemodialysis), including all relevant English-language articles published between January 1995 and September 2021. MAIN MESSAGE: The main types of permanent vascular access for HD are arteriovenous fistulas, arteriovenous grafts, and central venous catheters. A pragmatic, patient-centred approach is required when choosing the type of access for an individual. Common complications of vascular access creation include thrombosis, central venous stenosis, dialysis access steal syndrome, and arteriovenous fistula aneurysms. CONCLUSION: Family physicians play an important role in the clinical assessment and monitoring of HD vascular access. A thorough clinical assessment can detect a failing arteriovenous fistula and any associated complications, which can allow for prompt investigation and intervention to restore functionality, maintain access longevity, and improve patient quality of life.
OBJECTIVE: To provide family physicians with an evidence-based overview on the various methods of vascular access for hemodialysis (HD) and to provide a framework for the clinical assessment of HD access. SOURCES OF INFORMATION: A MEDLINE literature search was conducted using the MeSH terms arteriovenous fistula, arteriovenous graft, central venous catheter, and hemodialysis (or haemodialysis), including all relevant English-language articles published between January 1995 and September 2021. MAIN MESSAGE: The main types of permanent vascular access for HD are arteriovenous fistulas, arteriovenous grafts, and central venous catheters. A pragmatic, patient-centred approach is required when choosing the type of access for an individual. Common complications of vascular access creation include thrombosis, central venous stenosis, dialysis access steal syndrome, and arteriovenous fistula aneurysms. CONCLUSION: Family physicians play an important role in the clinical assessment and monitoring of HD vascular access. A thorough clinical assessment can detect a failing arteriovenous fistula and any associated complications, which can allow for prompt investigation and intervention to restore functionality, maintain access longevity, and improve patient quality of life.
Authors: Lucien E M Duijm; Ylian S Liem; Rob H H van der Rijt; Ferenc J Nobrega; Harrie C M van den Bosch; Petra Douwes-Draaijer; Philippe W M Cuypers; Alexander V Tielbeek Journal: Am J Kidney Dis Date: 2006-07 Impact factor: 8.860
Authors: J Malik; V Tuka; Z Kasalova; E Chytilova; M Slavikova; P Clagett; I Davidson; B Dolmatch; D Nichols; M Gallieni Journal: J Vasc Access Date: 2008 Jul-Sep Impact factor: 2.283
Authors: Dheeraj K Rajan; Timothy W I Clark; Nikunj K Patel; S William Stavropoulos; Martin E Simons Journal: J Vasc Interv Radiol Date: 2003-05 Impact factor: 3.464
Authors: Roberto Pecoits-Filho; Ikechi G Okpechi; Jo-Ann Donner; David C H Harris; Harith M Aljubori; Aminu K Bello; Ezequiel Bellorin-Font; Fergus J Caskey; Allan Collins; Alfonso M Cueto-Manzano; John Feehally; Bak Leong Goh; Kitty J Jager; Masaomi Nangaku; Muhibur Rahman; Manisha Sahay; Abdulkarim Saleh; Laura Sola; Rumeyza Turan Kazancioglu; Rachael C Walker; Robert Walker; Qiang Yao; Xueqing Yu; Ming-Hui Zhao; David W Johnson Journal: Kidney Int Suppl (2011) Date: 2020-02-19