2011 update <scp>J</scp>apanese <scp>S</scp>ociety for <scp>D</scp>ialysis <scp>T</scp>herapy Guidelines of Vascular Access Construction and Repair for Chronic Hemodialysis

Kukita, Kazutaka; Ohira, Suguru; Amano, Izumi; Naito, Hisao; Azuma, Nakanobu; Ikeda, Kiyoshi; Kanno, Yutaka; Satou, Takashi; Sakai, Shinji; Sugimoto, Tsuneaki; Takemoto, Yoshiaki; Haruguchi, Hiroaki; Murata, Jun; Miyata, Akira; Murotani, Noriyoshi; Hirakata, Hideki; Tomo, Tadashi; Akizawa, Tadao

doi:10.1111/1744-9987.12296

Cited by 169 publications

(215 citation statements)

References 211 publications

(271 reference statements)

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“…In this study, the diameters of the artery and vein were not assessed; however, our hospital creates AVF when the diameters of the artery and vein are more than 1.5 to 2 mm with mapping by ultrasonography [7,8]. As this study is from a single center, there seems to be little variability of the diameter of the artery and vein used for VA creation.…”

Section: Discussionmentioning

confidence: 97%

Factors associated with early failure of vascular access in acute-phase patients

et al. 2016

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Background: Acute-phase patients sometimes require hemodialysis therapy without vascular access (VA) present on admission. These patients require VA creation to continue hemodialysis after discharge. The risk of early VA failure in acute-phase conditions is considered high due to the unstable nature of the patients' condition. Hence, optimal timing of VA creation is not established. Methods: This retrospective study included patients who had VA (arteriovenous fistula or graft) created between May 2010 and July 2016. Results: During this study, 913 VA creations were performed among 804 patients. Of the included, 435 were acute-phase patients (275 men, 160 women). The average age was 67.4 ± 14.7 years. The causes of admission were exacerbation of renal failure (274 patients, 63.0 %), heart disease (61 patients, 14.0 %), infectious disease (30 patients, 6.9 %), and malignancy (15 patients, 3.4 %). Early VA failure occurred in 53 patients (12.2 %). There was no difference in causes of admission between patients with and without VA failure. Serum albumin level was significantly lower (2.7 ± 0.8 g/dL vs. 3.0 ± 0.6 g/dL, P < 0.01) in the early VA failure group than in the without early failure group. Albumin level was associated with early VA failure (odds ratio 0.4723, 95 % confidence interval 0.2744-0.8130, P < 0.01). Assessing only patients with arteriovenous fistula, the serum albumin level was significantly lower (2.6 ± 0.7 g/dL vs. 3.1 ± 0.6 g/dL, P < 0.01) in the early VA failure group than in the without early failure group. Conclusions: When we perform VA creation in acute-phase patients, hypoalbuminemia is associated with the risk of early VA failure. The status of the patient is an important factor to consider when creating VA.

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Section: Discussionmentioning

confidence: 97%

Factors associated with early failure of vascular access in acute-phase patients

et al. 2016

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“…The native arteriovenous (AV) fistula is widely recognized as the vascular access of first choice for most hemodialysis patients in that it has a lower frequency of complications compared with other types of vascular access [1][2][3]. In addition to an older age, female gender, and a history of diabetes, obesity was shown to be a significant risk factor for failure to achieve an AV fistula [4].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple access attempts result in poor patient satisfaction and unnecessary costs [12] and so must be avoided. Thus, as ultrasound-guided puncture in difficult AV fistula access is described in the recent Japanese vascular access guideline [3], this method has attracted attention. Furthermore, as a study on daily hemodialysis suggested, frequent cannulation can influence the patency of an AV fistula [13].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided cannulation of hemodialysis access

2016

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Because hemodialysis therapy cannot be performed without the cannulation of a vascular access, establishing a well-functioning vascular access is crucial. Recently, the number of patients with difficult arteriovenous (AV) fistula cannulation has increased due to changes in the epidemiology of the dialysis population. To address this issue, indications for real-time ultrasound-guided techniques have recently been reported. This review discusses methods of ultrasound-guided cannulation of dialysis access; it is difficult to cannulate a deep, small, or stiff vessel of an AV fistula on the first attempt with static ultrasound guidance in which the ultrasound probe remains stationary. Mastering a method in which the precise location of the needle tip can be continuously identified during the insertion by dynamic probe scanning is required. To achieve this, understanding the theory of ultrasound guidance, off/on-the-job training, and a sense of professionalism are important. The use of ultrasound also enables the safe catheter placement into a collapsed central vein and repeated direct puncture of a femoral vein. The latter reduces the risk of catheter-related blood stream infection by avoiding the use of an indwelling dual-lumen catheter. In conclusion, ultrasound-guided techniques enable precise vascular cannulation, which can result in significant patient and financial impact. The accumulation of further reports is required for the method to be acknowledged as the standard to cope with difficult vascular access for dialysis. As most of the latest ultrasound machines for procedural guidance are optimized for peripheral nerve block, a compact and affordable ultrasound device with image quality focused on vascular access is also needed.

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“…3 It was postulated to reduce access blood flow if exceeded 2 L/min or cardiac index was higher than 3.0 L/min/m 2 , and after solving anemia, over hydration and hypertension. 3,4 Among various options for vascular access flow restriction, [3][4][5][6][7][8] there are methods allowing for standardized inflow decrease. 9,10 The aim of the study is to present the utility of external dilator-assisted banding (EDAB) with no endovascular catheterization.…”

Section: Introductionmentioning

confidence: 99%

External dilator-assisted banding for high-flow hemodialysis arteriovenous fistula

et al. 2016

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Creation of arteriovenous fistula (AVF) may lead to left ventricle hypertrophy and predispose for development or worsening of heart failure. It was postulated to reduce access blood flow if exceeded 2 L/min or cardiac index was higher than 3.0 L/min/m 2 . Numbers of techniques decreasing flow were described. The major disadvantage was the complexity of procedure and necessity of intraoperative flow measurement needed to establish desired flow. The technique of dilatorassisted banding with no endovascular catheterization is presented. After blunt dissection non absorbable thread was placed around vessel and tied over the dilator. Then the dilator was gently removed and blood flow was confirmed by palpation. We performed 12 banding procedures. Mean brachial blood flows were 3733.2 ± 826.2 mL/min preoperatively and 1461.2 ± 337.7 mL/min after surgery. Mean flow reduction was 2272.2 ± 726.9 mL/min. The external dilator-assisted banding is a feasible method for vascular access flow reduction without necessity of endovascular catheterization. ARTICLE HISTORY

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2011 update Japanese Society for Dialysis Therapy Guidelines of Vascular Access Construction and Repair for Chronic Hemodialysis

Cited by 169 publications

References 211 publications

Factors associated with early failure of vascular access in acute-phase patients

Factors associated with early failure of vascular access in acute-phase patients

Ultrasound-guided cannulation of hemodialysis access

External dilator-assisted banding for high-flow hemodialysis arteriovenous fistula

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