Dialysis Access Management

This practical book covers the basic principles and practice of dialysis access management, a crucial part of the care of patients undergoing hemodialysis. It has been written in an easy-to-read, step-by-step format to help facilitate learning and understanding of the procedures and has been supplemented with numerous operative photographs and diagrams demonstrating the commonly performed dialysis access exams, interventions, procedures and surgeries. Dialysis access management is an essential text for residents, fellows and physicians who are learning or practicing in dialysis and/or dialysis access management, especially in the fields of nephrology, radiology, surgery and vascular medicine.

This comprehensive reference on the fundamentals of hemodialysis access creation and advanced management for maintenance is designed to meet the needs of all surgeons and physicians responsible for the treatment and care of patients undergoing dialysis. The book opens by discussing every aspect of dialysis access planning, including selection of the right access for the individual patient and access strategies. Hemodialysis access techniques, from the most basic to the most complex and unconventional, are then described step by step, and guidance is provided on follow-up. Detailed attention is also devoted to the challenging management of specific complications of dialysis access surgery, including failing hemodialysis access. The book includes a wealth of informative, high-quality images and illustrations, and the authors are prominent vascular surgeons, transplant surgeons, general surgeons, nephrologists, and interventional radiologists from across the United States.

"The renal failure and hemodialysis dependent population is increasing worldwide. Hemodialysis access is the life-line of these patients. Hemodialysis access related surgical and interventional procedures form a major demand to the healthcare services in many developed and developing countries. As such, the proper clinical decision, planning and performance of these procedures will greatly benefit the hemodialysis patients and reduce unnecessary healthcare costs. This book is a practical guide for clinicians and nurses creating, treating or managing hemodialysis accesses for renal failure patients. Basic principles to manage common or difficult situations of hemodialysis access are discussed and illustrative clinical cases are shown as examples. This book is an essential reading material for healthcare professionals in their early phase of developing the hemodialysis access program, while providing useful tips and tricks to established clinicians that will broaden their armamentarium."--

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.

Decision-making regarding the route of access to minimize procedural complications, especially in patients with unusual or complicated vascular anatomy, is extremely important for successful vascular access surgery. Several techniques for vascular access are widely disputed in the context of achieving optimal clinical outcomes. This book discusses various clinical aspects of vascular access to enrich our knowledge and understanding of the contemporary methodology and management of vascular access for a broad range of purposes. In four sections, this book examines the following topics: 1. Vascular Access: Methodology and Contemporary Management; 2. Vascular Access and Reparative Surgery; 3. Vascular Access Failure; and 4. Risk Stratification in Vascular Access.

Not only are dialysis access creation and maintenance prone to complications, but patients suffering from end-stage renal disease and its comorbidities generally have a high risk of adverse events during their continuous treatment. Preventive strategies are key to avoid harm and to improve the outcome of the treatment of the growing number of patients with chronic kidney failure, especially as doctors and nurses are not always aware of the consequences of unsafe behavior. This publication is intended for health care professionals – nurses as well as doctors – and aims to raise the awareness of patient safety aspects, combining medical education with evidence-based medicine. After a general overview of the topic, an international panel of authors provides a diversified insight into important concepts and technical tricks essential to create and maintain a functional dialysis access.

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. Contents: Dialysis Access: Past, Present and Future (J A Akoh); Modality Selection and Patient Outcome (K Farrington); Continuous Quality Improvement Through Clinical Pathways (K L Brayman & P Wallace); The Access Clinic (D M Manas); Recirculation and Dialysis Access (P W Chamney); The Value of Ultrasonic Imaging in Defining the Anatomy for Vascular Access (A Eltayar et al.); Anaesthetic Management (P Korsah & N Pace); Arteriovenous Fistulas (N S Hakim); Use of Autogenous Vein or Synthetic Grafts (A G Hakaim & W A Oldenburg); Complications of Vascular Access (K M Rigg); Revision Access Surgery (P A Lear); Central Venous Catheters (J A Akoh); Access for Paediatric Patients (O N Fernando); Radiology of Access (A Al-Kutoubi); Peritoneal Dialysis Access (M A Akyol); Nursing Care of Patients with Dialysis Access (J Emery). Readership: Transplant surgeons, vascular surgeons, nephrologists, trainees and nurses.

Telemedicine and remote patient monitoring are innovative tools to provide remote transmission, interpretation, and storage of data for review by the care team. These tools allow for accurate home monitoring of patients enabling the team to improve care through prevention and early identification of problems. This book is structured into four main parts. The first describes the evolution of peritoneal dialysis and related technology. The second part summarizes current unmet clinical needs reported by patients and care teams, the need for innovation in the field, and the technical and clinical issues involved with the modern management of peritoneal dialysis. The third section presents the operational characteristics of the new information communication technology system and, in detail, the features of the Sharesource platform. Finally, a series of field experiences by expert users are reported to describe the benefits and the potential applications of remote patient monitoring in the future. Telemedicine and remote patient monitoring have proven to be useful in the care of patients on peritoneal dialysis. The scope of this publication, therefore, is to present the experiences of clinical key opinion leaders who have been using the application.