Guidelines on vascular access for hemodialysis from the Brazilian Society of Angiology and Vascular Surgery

Abstract

Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis.

Educational video for self-care with arteriovenous fistula in renal patients: randomized clinical trial

“…It should be noted that health education actions aimed at patients about vascular access are recommended by the main guidelines available ( 9 - 12 ) . In addition, the adoption of these actions, when they take a patient-centered approach, with an analysis of their knowledge needs, can make them the protagonists in clinical decision-making regarding their state of health ( 19 ) .…”

“…In order to help the patient, the main guidelines available recommend carrying out educational actions aimed at them about vascular access ( 9 - 12 ) . In this context, educational technologies, as a potential strategy for professional practice, in addition to offering support, are able to provide the necessary support and guidance for care, as well as tending to increase the patient’s knowledge, with a view to promoting health and quality of life ( 13 ) .…”

Challenges of maintaining hemodialysis in Brazil

“…In recent years, we have observed greater attention to HD access, highlighting specific groups in Brazil to study the topic. The Vascular Forum with Dr. Walter Boim 5 and the Save Group, with doctors Leonardo Harduin, Leonardo Cortizo, Thiago Barroso, and Márcio Filippo, are the most prominent 6 . These groups have encouraged the discussion of innovative treatments and scientific publications, including national guidelines 6 .…”

“…The Vascular Forum with Dr. Walter Boim 5 and the Save Group, with doctors Leonardo Harduin, Leonardo Cortizo, Thiago Barroso, and Márcio Filippo, are the most prominent 6 . These groups have encouraged the discussion of innovative treatments and scientific publications, including national guidelines 6 . All this is so that accesses last longer and patients use fewer catheters.…”

“…All this is so that accesses last longer and patients use fewer catheters. There are already devices with excellent results, such as stent grafts with national technology 7 . Surgical techniques developed or improved in Brazil have been recently published.…”