Spanish Clinical Guidelines on Vascular Access for Haemodialysis

Ibeas, José; Roca-Tey, Ramón; Vallespín, Joaquín; Moreno, Teresa; Moñux, Guillermo; Martí-Monrós, Anna; Pozo, José Luís del; Gruss, Enrique; Arellano, Manel Ramírez de; Fontseré, Néstor; Arenas, María Dolores; Merino, José Luis; García-Revillo, J.; Caro, Pilar; López-Espada, C.; Giménez-Gaibar, Antonio; Fernández-Lucas, Milagros; Valdés, Pablo; Fernández-Quesada, Fidel; Fuente, Natalia de la; Hernán, David; Arribas, Patricia; Nieta, María Dolores Sánchez de la; Martínez, María Teresa; Barba, A.; Vascular, por el Grupo Español Multidisciplinar del Acceso

doi:10.1016/s2013-2514(19)30100-2

Cited by 65 publications

(160 citation statements)

References 813 publications

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“…Grupo Español Multidisciplinar del Acceso Vascular (GEMAV) [35] We suggest that antiplatelet therapy for thrombosis prophylaxis of native AV fistula be indicated on a case-by-case basis, because although it shows a decrease in the risk of thrombosis, we believe that adverse effects have not been studied with sufficient accuracy.…”

Section: Esvs [34]mentioning

confidence: 99%

“…GEMAV [35] We recommend a priority be placed on attempting to restore the patency of potentially recoverable thrombosed AV fistulas, preferably within the first 48 h. In all cases, the priority should be to salvage the AV fistula and avoid central venous catheter placement.…”

Section: Esvs [34]mentioning

confidence: 99%

“…GEMAV [35] We recommend an imaging test be carried out after restoring AV fistula patency. This should be performed immediately after thrombectomy to detect any possible stenoses requiring treatment.…”

Section: Esvs [34]mentioning

confidence: 99%

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Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Gallieni

Hollenbeck

Inston

et al. 2019

Nephrology Dialysis Transplantation

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103

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Chapter 2. Surgical and endovascular interventions for promoting arteriovenous fistula maturation 2.1. We suggest using regional block anaesthesia rather than local anaesthesia for arteriovenous fistula creation in adults with end-stage kidney disease. (2C) 2.2. We suggest there is insufficient evidence to support endof-vein to side-of-artery over side-of-vein to side-ofartery anastomosis for arteriovenous fistula creation in adults with end-stage kidney disease (2C) peri-and postoperative care of AV fistulas and grafts ii3

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Section: Esvs [34]mentioning

confidence: 99%

Section: Esvs [34]mentioning

confidence: 99%

See 1 more Smart Citation

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Gallieni

Hollenbeck

Inston

et al. 2019

Nephrology Dialysis Transplantation

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103

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“…D'altro canto, l'ECD è operatore-dipendente e richiede personale addestrato che non sempre è reperibile nei centri dialisi. Invece la fistolografia, nonostante rappresenti il gold standard nella diagnosi di stenosi, è raccomandata nel caso in cui l'indagine ecografica non sia diagnostica e se persiste il sospetto di stenosi emodinamicamente significativa (13). Il principale limite dello studio è rappresentato dal piccolo numero dei pazienti provenienti da un unico centro.…”

Section: Discussioneunclassified

Stima della portata della fistola artero-venosa mediante termodiluizione nei pazienti in emodialisi cronica: esperienza monocentrica.

et al. 2020

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mediante il costante monitoraggio del flusso è una premessa essenziale per raggiungere l'adeguatezza dialitica e il mantenimento della FAV.Le Linee Guida 2006 della National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) indicano che una sorveglianza della fistola, sia essa nativa o protesica, può permettere in caso di stenosi un tempestivo intervento correttivo e migliorare così la pervietà del vaso e diminuire l'incidenza dell'ostruzione. Le stenosi emodinamicamente significative infatti riducono il flusso, aumentano le turbolenze nel lume e spingono le piastrine contro la parete del vaso, favorendone l'attivazione (3).Oltre alle tecniche dirette come l'Eco-Color-Doppler (ECD) ci sono anche tecniche indirette di misurazione del flusso della FAV che possono essere eseguite direttamente al letto del paziente durante il trattamento emodialitico.Le tecniche impiegate sono la termodiluizione, la diluizione a ultrasuoni, la dialysance ionica e l'otticodiluizione. Tutte queste si basano sulla formula introdotta da Krivitski, che prevede la stima del flusso dell'accesso vascolare Flow estimate of arteriovenous fistula by thermodilution in patients on chronic hemodialysis: monocentric experience Purpose: Vascular access surveillance in hemodialysis is today an important challenge for nephrologist. Low blood flow is a risk factor for development of thrombosis of native fistula or graft. The aim of the study is to evaluate the correspondence between flow measurements by thermodilution and Color Doppler, and to identify flow rate values using the Blood Temperature Monitor (BTM) method in the case of stenosis. Methods: We evaluated 29 patients on chronic hemodialysis. The evaluations of blood flow with BTM were performed during the first hour of the hemodialysis session. All patients underwent a Color Doppler of vascular access within 10 days from the BTM measurements. Results: The mean vascular access flow calculated with BTM resulted 1142 ± 700 mL/min and there was a correlation with Color Doppler data 1199 ± 644 mL/min (p = 0,0001 r = 0,829). The flow of patients with hemodynamically significant stenosis was 332 ± 92 mL/min with a minimum value of 270 mL/min and a maximum value of 440 mL/min. Conclusions: The correspondence between thermodilution and Color Doppler supports the implementation of intradialitic evaluation of the vascular access blood flow with the BTM method. Thermodilution allows to identify earlier patients with high risk of vascular access failure and the need for further diagnostic and therapeutic investigations.

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“…In the presence of significant arteriovenous fistula (AVF) stenosis, there is almost always a reduction of the Qa, independent of the kind of arteriovenous shunt, anatomical location, or stenosis topography 4,5 . Ultrasound dilution (UD) is often referenced as the gold -standard, but unfortunately, a true gold -standard for in vivo non--invasive Qa measurement does not exist 6,7 . UD methods are highly reproducible but also suffer from potential measurement errors mainly related to inadequate mixing of the indicator solution, for example, due to aneurysmatic outflow veins or needle orientation and position 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

Diniz¹,

Coentrão²

2020

pjnh

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Recently, the European Renal Best Practice (ERBP) clinical practice guidelines on hemodialysis VA stated that the evidence for surveillance in addition to clinical monitoring is inconclusive 11. Still, DUS Qa measurement is a very useful tool in vascular access care that is being increasingly adopted by nephrologists in their daily clinical practice. All the clinicians involved in VA care should be familiar with its advantages, disadvantages, and potential pitfalls, as well as its reliability and correlation with other methods in chronic kidney disease patients. DUPLEX ULTRASOUND-THEORY AND TECHNICAL CONSIDERATIONS Ultrasound is an imaging technique that allows the investigation of the VA through the use of a transducer capable of emitting and receiving ultrasounds and converting them to an electrical signal. This signal is analyzed by a processor and, based on the amplitude of the signal received, a gray-scale image is displayed on the screen of the ultrasound machine 12. The use of Doppler ultrasound for the detection of blood flow in the hemodialysis VA was reported for the first time in 1971, following the increasing use of the Doppler ultrasonic flowmeter as an adjuvant in the diagnosis and management of vascular disease at the time 13. The simplest and most widely available method

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Spanish Clinical Guidelines on Vascular Access for Haemodialysis

Cited by 65 publications

References 813 publications

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults

Stima della portata della fistola artero-venosa mediante termodiluizione nei pazienti in emodialisi cronica: esperienza monocentrica.

Doppler Ultrasound in Vascular Access care: the pearls and pitfalls of flow volume measurement

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