Document Detail


Epidemiology and blood flow surveillance of the native arteriovenous fistula: a review of the recent literature.
MedLine Citation:
PMID:  19379367     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Vascular access placement is a key management issue for hemodialysis patients. Despite being well regarded as the access of first choice, the native arteriovenous fistula (AVF) remains underutilized in the United States. The first part of this review examines recent epidemiology studies addressing patient factors associated with the use of the synthetic arteriovenous graft as opposed to the native fistula. Female gender and older age are consistently associated with a higher frequency of graft use. Diabetes, peripheral vascular disease, and body mass index were associated with graft use in some but not all of the studies. Recent evidence also suggests an independent survival advantage for patients dialyzing via native fistulae especially for infection-related mortality. The second part reviews evidence surrounding the recommendations for blood flow surveillance of the native fistula. The hemodynamic features of the native fistula are examined and differences from synthetic grafts are highlighted. Clinical studies assessing the use of blood flow surveillance to prevent the sudden thrombosis of native fistulae are reviewed. Blood flow thresholds for further investigation are yet to be determined definitely for AVF and randomized studies should be performed to assesses the impact on AVF thrombosis rates.
Authors:
K R Polkinghorne; P G Kerr
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  7     ISSN:  1492-7535     ISO Abbreviation:  Hemodial Int     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  209-15     Citation Subset:  -    
Affiliation:
Department of Nephrology, Monash Medical Center, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Clayton, Victoria, Australia. kevan.polkinghorne@med.monash.edu.au
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