Hemodialysis vascular access management in the Netherlands

The Journal of Vascular Access
J H M TordoirNoud Peppelenbosch

Abstract

In the Netherlands, 86% of patients start renal replacement therapy with chronic intermittent hemodialysis (HD). Guidelines do indicate predialysis care and maintenance of a well-functioning vascular access (VA) as critical issues in the management of the renal failure patient. Referral to the surgeon and time to VA creation are important determinants of the type and success of the VA and HD treatment. Data from a national questionnaire showed that time from referral to the surgeon and actual access creation is <4 weeks in 43%, 4 to 8 weeks in 30% and >8 weeks in 27% of the centers. Preoperative ultrasonography and postoperative access flowmetry are the diagnostic methods in the majority of centers (98%). Most facilities perform rope-ladder cannulation with occasionally the buttonhole technique for selected patients in 87% of the dialysis units. Endovascular intervention for thrombosis is practiced by 13%, surgical thrombectomy by 21% and either endovascular or surgery by 66% of the centers. Weekly multidisciplinary meetings are organized in 57% of the units. Central vein catheters are inserted by radiologists (36%), nephrologists and surgeons (32%). We conclude that guidelines implementation has been successful in particular r...Continue Reading

References

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Apr 25, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Henricus J T A M HuijbregtsUNKNOWN CIMINO Members
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Citations

Mar 16, 2017·The Journal of Vascular Access·Alexander LamprouClark Zeebregts
Jan 7, 2017·The Journal of Vascular Access·George S GeorgiadisChristos Argyriou

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