Abstract
Background and Aims
Vascular Access (VA) is the lifeline of hemodialysis patient. The universal goal of access monitoring is to identify access stenosis and enable intervention prior to thrombosis; thereby, maximizing access longevity and minimizing morbidity. The advent and use of techniques including dynamic and static venous pressure monitoring, physical examination, access flow measurement, imagining and combined imaging and flow monitoring by duplex ultrasound demonstrate that it is possible to predict which accesses are at high risk for future thrombosis.
Currently arteriovenous fistula (AVF) and arteriovenous graft (AVF) have been recognized as the permanent access. This study takes advantage of the opportunity to utilize data from 19 associated Dialysis Clinics to examine trends in VA use, trends in patient characteristics and practice associated with VA.
Determine the status quo of the overall information related to the VA to start a five years follow up study with the aims to reduce VA complications 8stenosis and thrombosis) and related hospitalization days to improve patient’s quality of life.
Method
VA data were collected for each patient at study entry. Practice pattern data from the facility medical director, nurse manager and VA surgeon were also analyzed. We have developed a mask on the management database to implement the first level monitoring of access and collected data at each treatment (Fig.1)
Results
Average age of 801 patients enrolled was 73,5 years. Native AVF was used by 79%, AVG by 2% and CVC by 19%. As the age increase as well as he use of CVC move from 6% (15-39(years) to 50,5% in patients with more than 85 years. Most frequent complications were: Thrombosis 16,5 %, Infectios 5,5%. Related VA hospitalization days are 28,7 % of total days. Average dialysis goals achieved were: QB 290 ml/Min; blood processed 69,7 L; KT/V:1,35.
Conclusion
By interpreting collecting data for specific performance measures using accurate reports allow health care professionals to highlight the VA performance/inefficiences and provide correct information to the clinical staff to support them in their daily clinical practice and decision making.
Survival and infection rates of a polyurethane vascular access graft compared to tunnelled dialysis catheters and brachiobasilic arteriovenous fistulas
