Need for Vascular Access in CAPD Patients in Brazil

Filho, José C. Divino; Almeida, FP; Lobo, Edson José; Boccato, N.; Morón, Juan María Vázquez; Linardi, Felipe de Francisco; Costa, José Abrão Cardeal da

doi:10.1159/000419746

Cited by 1 publication

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“…With the exception of a Brazilian study by Divino Filho et al (8), all the articles available in the literature on the topic, even if different in study design, seem to lead to the same conclusion as the Danish study. The study by Divino Filho et al is peculiar because of the influence of economic factors on renal unit clinical policy.…”

Section: Evidentiary Basementioning

confidence: 87%

Vascular Access Planning in Peritoneal Dialysis Patients

et al. 2008

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Peritoneal dialysis (PD) is a well-established renal replacement therapy for end-stage renal disease patients. Nonetheless, on an annual basis, at least 10% of patients shift from PD to hemodialysis for a variety of reasons. Thus the issue of vascular access creation needs to be addressed for this small but significant group of patients. Despite the relatively consistent number of dropouts, the creation of an arteriovenous fistula prior to transfer remains suboptimal, and variable from center to center. Literature for this specific area is poor and dated. Guidelines seem to suggest vascular access creation in high-risk failure patients, but they have no detailed criteria to select patients that would likely fail PD and therefore take advantage of a backup access. There is a need to better understand and predict patients that require conversion to hemodialysis to develop a plan that focuses on wellness and maximum quality of life in the lifecycle of PD patients. This review addresses the issue of vascular access planning in adult PD patients, presents the available literature on the topic and the current guidelines and recommendations, and describes a research agenda to guide decision making in clinical practice.

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Section: Evidentiary Basementioning

confidence: 87%