Why Do So Many Patients Have a Dialysis Catheter and Not Arteriovenous Fistulae or Grafts?
Identifieur interne : 002753 ( Main/Exploration ); précédent : 002752; suivant : 002754Why Do So Many Patients Have a Dialysis Catheter and Not Arteriovenous Fistulae or Grafts?
Auteurs : L. Troidle [États-Unis] ; T. Eisen [États-Unis] ; F. O. Finkelstein [États-Unis]Source :
- Hemodialysis International [ 1492-7535 ] ; 2004-01.
Abstract
The Dialysis Outcome and Quality Initiative has guidelines for vascular access and states that the dialysis catheter (DC) should be limited to less than 20% of the end‐stage renal disease (ESRD) patients. Our center has found this target difficult to achieve. Objective: We wondered what the reasons for use of a DC might be. Methods: We noted the number of patients with a DC in place and assessed the reasons why the DC was being used on 8/1/03. Results: 73 of the 170 (42.9%) patients had a DC on 8/1/03. 24 (32.9%) of the patients refused to have initial arteriovenous fistulae or grafts (AVF/G) or a secondary AVF/G revision or replacement procedure performed after initial AVF/G failure. 15 (20.5%) patients had a maturing AVF/G, 12 (16.4%) had significant medical and/or surgical contraindications for AVF/G placement, 9 (12.3%) patients were awaiting surgical thrombectomy, revision or placement of AVF/G, 6 patients (8.2%) were awaiting transfer to CPD therapy, 4 (5.5%) patients were undecided about having an AVF/G placed, and 1 (1.4%) had acute renal failure and early ESRD recovery was expected. Only 2 (2.7%) patients had no access plan by the nephrology team. Conclusions: Patients' refusal for an AVF/G placement and patients with a maturing AVF/G or awaiting surgical revision or placement were the most common reasons for the use of a DC in our center. To significantly impact on the high use of the DC, it would be crucial to better understand the reasons for patients’ refusals.
Url:
DOI: 10.1111/j.1492-7535.2004.0085h.x
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Finkelstein</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Renal Research Institute, New Haven, CT</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Hemodialysis International</title><title level="j" type="alt">HEMODIALYSIS INTERNATIONAL</title><idno type="ISSN">1492-7535</idno><idno type="eISSN">1542-4758</idno><imprint><biblScope unit="vol">8</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="80">80</biblScope><biblScope unit="page" to="81">81</biblScope><biblScope unit="page-count">100</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-01">2004-01</date></imprint><idno type="ISSN">1492-7535</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1492-7535</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The Dialysis Outcome and Quality Initiative has guidelines for vascular access and states that the dialysis catheter (DC) should be limited to less than 20% of the end‐stage renal disease (ESRD) patients. Our center has found this target difficult to achieve. Objective: We wondered what the reasons for use of a DC might be. Methods: We noted the number of patients with a DC in place and assessed the reasons why the DC was being used on 8/1/03. Results: 73 of the 170 (42.9%) patients had a DC on 8/1/03. 24 (32.9%) of the patients refused to have initial arteriovenous fistulae or grafts (AVF/G) or a secondary AVF/G revision or replacement procedure performed after initial AVF/G failure. 15 (20.5%) patients had a maturing AVF/G, 12 (16.4%) had significant medical and/or surgical contraindications for AVF/G placement, 9 (12.3%) patients were awaiting surgical thrombectomy, revision or placement of AVF/G, 6 patients (8.2%) were awaiting transfer to CPD therapy, 4 (5.5%) patients were undecided about having an AVF/G placed, and 1 (1.4%) had acute renal failure and early ESRD recovery was expected. Only 2 (2.7%) patients had no access plan by the nephrology team. Conclusions: Patients' refusal for an AVF/G placement and patients with a maturing AVF/G or awaiting surgical revision or placement were the most common reasons for the use of a DC in our center. To significantly impact on the high use of the DC, it would be crucial to better understand the reasons for patients’ refusals.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Connecticut</li></region></list><tree><country name="États-Unis"><region name="Connecticut"><name sortKey="Troidle, L" sort="Troidle, L" uniqKey="Troidle L" first="L." last="Troidle">L. Troidle</name></region><name sortKey="Eisen, T" sort="Eisen, T" uniqKey="Eisen T" first="T." last="Eisen">T. Eisen</name><name sortKey="Finkelstein, F O" sort="Finkelstein, F O" uniqKey="Finkelstein F" first="F. O." last="Finkelstein">F. O. Finkelstein</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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