Publisher: Karger Medical and Scientific Publishers
ISBN: 9783805576512
Category: Medical
Page: 472
View: 749
Recent developments have spurred a renewed interest in novel solutions to access the patient circulation, mainly concentrating on vascular access for renal replacement therapies and on peritoneal dialysis access.Starting with the epidemiology, the focus then shifts to the evolution of new techniques and monitoring procedures with regard to hemodialysis, which are discussed and evaluated. Attention is also paid to the new biomaterials available, concentrating on their improved biocompatibility and surface characteristics. As developments in the field of peritoneal dialysis have taken a similar turn, new devices providing access to the peritoneal cavity which have recently been made available are introduced next. Last but not least, the management of complications and the continuous maintenance and care of the access with regard to both hemodialysis and peritoneal dialysis are highlighted.This book provides a complete overview of the devices, catheters and methods currently available to ensure successful vascular and peritoneal access. Taking into account both the physiology of the extracorporeal circulation and the mechanisms of peritoneal dialysis with regard to the most adequate access techniques, this is a unique resource for clinicians, investigators and researchers in the field of renal replacement therapy.
This comprehensive reference details the techniques for establishing vascular access for hemodialysis and other acute and chronic conditions that require access to the circulation along with peritoneal dialysis access methods. Includes over 960 references and more than 160 tables, figures, and photographs. Vascular Access in Clinical
This book provides a comprehensive, state-of-the-art overview of interventional nephrology. Similar to the previous edition, this text describes a direct approach to clinical problems encountered by the community of care providers who treat chronic kidney disease and dialysis patients. Practical scenarios faced on a day-to-day basis are presented by experts in the field, utilizing the latest scientific information. The book also features updated therapeutic guidelines and fully revised and new chapters. Written by the foremost authorities in the field, Interventional Nephrology: Principles and Practice, Second Edition is a must-have resource for clinicians and practitioners who treat and manage patients with hemodialysis and peritoneal dialysis access problems.
When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.
The incidence of treated end stage renal disease (ESRD) continues to rise, particularly in the western world. Although renal transplantation is the treatment of choice for ESRD, the decline in the number of cadaveric organs, coupled with the rising demand for transplantation, means that an increasing number of patients will have to depend on dialysis. Vascular or peritoneal access is the Achilles' heel of any dialysis service.This book offers a clear description of the state of the art in providing and preserving a durable and reliable access. It also points the way to dialysis in the 21st century. The contributing authors are drawn from a wide background, with expertise in various aspects of dialysis access, including its history, the technique of placement, anaesthesia, radiology, nursing care and training of vascular access surgeons.There is currently a dearth of books on the subject of dialysis access. The few existing books on vascular access were written in the United States, with none from the UK. This volume is intended for use by transplant surgeons, general surgeons with an interest in vascular access, vascular surgeons, nephrologists, trainees and nurses. Dialysis services are expanding worldwide and this book is an invaluable guide for those involved in daily patient care and organisation of dialysis services.
A complete guide to every aspect of interventional nephrology—an essential text for students, residents, fellows, and clinicians This timely resource examines all relevant aspects of interventional nephrology, from the history of nephrology to the principles governing the latest vascular access techniques. Heavily illustrated with full-color procedural drawings and featuring an easy-to-follow design, the book includes contributions from many leading authorities in the field whose insights combine to form an unprecedented, clinically rigorous survey of interventional nephrology. Interventional Nephrology opens with an instructive look at the origins of hemodialysis access; an overview of the history of interventional nephrology in the U.S. and abroad; and clinically relevant coverage of vascular access outcomes. The high-yield coverage continues with a probing assessment of ethics, public policy, and practice guidelines, illuminating such pivotal topics as industry partnerships and conflicts of interest. The principles that support interventional nephrology techniques are also extensively reviewed, encompassing everything from vascular mapping to peritoneal dialysis catheter removal, while the following section delves into the key surgical aspects of vascular access. Finally, the book provides useful perspectives on how political and policy affairs impact current practice. FEATURES Illustrated with precise full-color drawings and radiographs that highlight both normal and vascular anatomy and clarify the management of vascular access problems Streamlined design and helpful pedagogy, including chapter-opening learning objectives, numerous tables, and concept-clarifying figures Complete overview of the core principles underlying interventional nephrology practice and techniques, covering vascular mapping, monitoring and surveillance of arteriovenous access, venous angioplasty, tunneled catheters, renal ultrasonography, and much more Discussion of vascular access in special populations and the role of pharmacologic agents in preserving vascular access provides evidence-based insights that are pertinent to the everyday practice of interventional nephrology In-depth emphasis on the surgical aspects of vascular access reviews sites, types, and creation of arteriovenous fistulae; secondary arteriovenous fistula; and surgical options for vascular anomalies Forward-thinking coverage of basic and translational science considers future directions in vascular access science; flow dynamics, maturity, and access failure; neointimal hyperplasia; pharmacologic prevention of access dysfunction; and device innovation
Dialysis Access: A Multidisciplinary Approach gives radiologists, nephrologists, and surgeons the complete knowledge base they need to deliver effective, coordinated care to dialysis patients with vascular access needs. This practical guide explains how to implement the National Kidney Foundation's Dialysis Outcomes Quality Initiative (DOQI) guidelines for vascular access and details procedures for creating vascular access...monitoring access failure...treating blocked access...and inserting and using catheters. Dr. Gray is the lead author for the Society of Cardiovascular and Interventional Radiology (SCVIR)'s Dialysis Access Reporting Standards. International contributors are expert interventional radiologists, nephrologists, and vascular access surgeons. Dialysis Access: A Multidisciplinary Approach fully integrates these specialties' perspectives.
This practical and comprehensive book provides "how-to" information on all aspects of access to the vascular system for hemodialysis, parenteral nutrition, chemotherapy, and resuscitation. Preoperative evaluation, operations, noninvasive procedures, complications, and other aspects are detailed. This edition provides increased coverage of non-interventional techniques and includes new chapters on management of thrombophilia in hemodialysis patients; modulation of the immune system to prevent myointimal hyperplasia; synthetic grafts; venous outflow stenting for salvage of vascular access procedures; and ultrasound in vascular access procedures. This book is essential for all clinicians treating patients who require vascular access, including vascular surgeons, general surgeons, nephrologists, dialysis technicians and nurses, radiologists, and cardiologists.
Chronic kidney disease and end stage renal disease (ESRD) is an epidemic in the U.S. and abroad. Dialysis is the major form of therapy to keep these patients with ESRD alive and functioning in society. Vascular access is the life line of hemodialysis. Yet, many general nephrologists are not familiar with the concepts that underpin this crucial subspecialty of nephrology. This book is a compendium of vascular access insights designed to augment the knowledge base of the general nephrologist. This book provides up to date information for the clinical practice of general nephrology as it applies to the care of vascular access. We have assembled international experts in the field of vascular access as authors to elaborate on the science and clinical practice of nephrology as it relates to arteriovenous fistulae and grafts, central venous catheters, peritoneal dialysis and vascular access mapping and surgery.
This book aims to educate general and vascular surgeons on all pertinent aspects of peritoneal dialysis (PD). Most surgeons get very little training in residency on this topic, and the use of PD is growing around the world. Much of the book will focus on implantation techniques, especially laparoscopic insertions. The authors will describe the known adjunct procedures that have been shown to decrease dysfunction rates. The aim is to provide greater patient autonomy, a better quality of life, preservation of residual renal function and a higher survival advantage.
End-stage kidney disease (ESKD) is a grave public health problem in the US affecting over 808,000 Americans in 2017. Options for treatment of ESKD include renal transplantation and peritoneal dialysis. However, the most common treatment for ESKD in the US is hemodialysis, with over 468,000 Americans being hemodialysis dependent in 2017. For hemodialysis-dependent patients, vascular access is required, for which there are two options that are considered permanent, typically created in the upper extremity: 1) fistula, created by surgically connecting a patient's own vein to an artery, and 2) graft, using a prosthetic tube as a conduit between artery and vein. However, evidence to support the choice of fistula vs graft in an individual patient is lacking. Frailty is a measure of patient global functional status and overall health that could be used in the decision-making progress to determine the optimal vascular access type for an individual patient. The objective of this dissertation is to investigate the association of frailty with probability of short-term vascular access failure to assess the usefulness of incorporating measurement of frailty into the vascular access decision-making process.I performed a quantitative analysis of the United States Renal Data Systems Registry which includes all hemodialysis dependent patients in the US. I determined the presence of frailty for each patient using a validated claims-based frailty indicator. I then assessed the association of frailty with time to fistula and graft functional use (the process of becoming usable for hemodialysis) using multivariable models. The analysis demonstrated that patients with increasing claims-based frailty indicator values have increasing length of time to fistula functional use. There was no association of claims-based frailty indicator value with time to graft functional use. The association between frailty and longer fistula functional use times has significant implications for clinical decision-making and guideline creation. Given that this study suggests frailty could also be associated with longer time to fistula functional use, frailty could serve as a strong indicator that fistula is not an appropriate choice of vascular access for that patient. Further, since increasing degrees of frailty, as measured by the claims-based frailty indicator, are associated with the highest risk of longer time to fistula m functional use in this study, it may be appropriate to consider patients with the highest levels of frailty as candidates for permanent access through a tunneled catheter.
This book is a thorough guide to dialysis that will assist in the effective treatment of patients. Current knowledge on all aspects of dialysis, including the most recent advances, is presented and the various techniques used in dialysis patients are described step by step. Both hemodialysis and peritoneal dialysis are fully considered. The coverage of hemodialysis explains the procedure and its indications and provides guidance on challenging topics such as vascular access, response to acute and chronic complications, and on-line hemodiafiltration. The discussion of peritoneal dialysis includes explanation of peritoneal physiology, the principles of prescription, and the treatment of peritonitis and exit site infection. A summary of updated dialysis-related guidelines is included at the end of the book. The lucid text is supported by more than 200 full-color illustrations that clarify anatomy, vascular/peritoneal access, and dialysis procedures and techniques. The Essentials of Clinical Dialysis will be of value for all who are involved in the management of dialysis patients and will be a helpful guide for training of physicians and healthcare associates in the dialysis center.
