Gef??zugang zur H?modialyse

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• 作者：Prof. Dr. J. Bommer (1)
  F. Port (2)
  
• 关键词：DOPPS ; Studie ; Arterioven?se Fisteln ; Gef??prothesen ; Dialysekatheter ; Komplikationen ; DOPPS study ; Arteriovenous fistula ; Graft ; Dialysis catheter ; Complications
• 刊名：Der Nephrologe
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：9
• 期：2
• 页码：117-124
• 全文大小：440 KB
• 参考文献：1. Pisoni RL, Arrington CJ, Albert JM (2009) Facility hemodialysis vascular access use and mortality in countries participating in DOPPS: an instrumental variable analysis. AmJ Kidney Dis 53:475-91 CrossRef
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  3. Ng LJ, Chen F, Pisoni RL (2011) Hospitalization risks related to vascular access type among incident US hemodialysis patients. Nephrol Dial Transplant 26:3659-666 CrossRef
  4. US Renal Data System (2009) USRDS 2009 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
  5. Goodkin DA, Mapes DL, Held PJ (2001) The dialysis outcomes and practice patterns study (DOPPS): how can we improve the care of hemodialysis patients? Semin Dial 14:157-59 CrossRef
  6. Malek T, Alvarez-Ude F, Gil MT et al (2008) Changes in vascular access in a dialysis unit in recent years: planning problems, change in preferences, or demographic change? Nefrologia 25:531-38
  7. Fissell RB, Fuller DS, Morgenstern H et al (2013) Hemodialysis patient preference for type of vascular access: variation and predictors across countries in the DOPPS. J Vasc Access 14:264-72 CrossRef
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  15. Bieber B, Li Y, Pisoni RL et al (2013) Frequent pre-dialysis nephrology care and later dialysis initiation are associated with arteriovenous access use at dialysis start: a DOPPS study. ASN Kidney Week, DOPPS Symposium, 07.11.2013, Poster Presentation TH-PO491
  16. Andrassy K, Ritz E, Schoeffner W et al (1971) The influence of acetylsalicylic acid on platelet adhesiveness and thrombotic fistula complications in hemodialysed patients. Klin Wochenschr 49:166-67 CrossRef
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  18. Hasegawa T, Elder SJ, Bragg-Gresham JL et al (2008) Consistent aspirin use associated with improved arteriovenous fistula survival among incident hemodialysis patients in the dialysis outcomes and practice patterns study. Clin J Am Soc Nephrol 3:1373-378 CrossRef
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• 作者单位：Prof. Dr. J. Bommer (1)
  F. Port (2)
  
  1. Dialysezentrum Heidelberg, Bergheimer Str. 59/61, 69115, Heidelberg, Deutschland
  2. University of Michigan School of Public Health, Ann Arbor, USA
  
• ISSN：1862-0418

文摘

The vascular access has a decisive influence on the success of chronic hemodialysis treatment. Vascular access and the associated complications are the main theme of the worldwide epidemiological DOPPS study. In this large observational study the adjusted mortality of patients with a catheter was approximately 30?% higher than with an arteriovenous (AV) fistula and 15?% higher with AV grafts. Simultaneously, the number of complications including the duration of hospital stay was increased in patients with catheters and AV grafts. In the last 10 years the number of catheters has increased in many countries, has remained at a high level in Belgium and Canada but decreased in the USA where the number of AV grafts also greatly decreased. The age of patients, diabetes, poor vascular conditions and finally the explicit wishes of patients and dialysis personnel increased the frequency of catheters and AV grafts. Experienced operators, early presentation of patients to nephrologists and timely placement of the vascular access, sufficient time before initiation and insight of dialysis personnel with respect to poor dialysis flow with catheters and increased risks of catheters and AV grafts compared to AV fistulas should contribute to an increase in the number of patients with AV fistulas so that the problem of vascular access will be improved.