Quality assessment in vascular access procedures for hemodialysis is not clearly defined. The aim of this article is to compare various guidelines regarding recommendation on quality control in angioaccess surgery. The overall population of end-stage renal disease patients and patients in need for hemodialysis treatment is growing every year. Chronic intermittent hemodialysis is still the main therapy. The formation of a functional angioaccess is the cornerstone in the management of those patients. Native (autologous) arteriovenous fistula is the best vascular access available. A relatively high percentage of primary failure and fistula abandonment increases the need for quality control in this field of surgery. There are very few recommendations of quality assessment on creation of a vascular access for hemodialysis in the searched guidelines. Some guidelines recommend the proportion of native arteriovenous fistula in incident and prevalent patients as well as the maximum tolerable percentage of central venous catheters and complications. According to some guidelines, surgeon's experience and expertise have a considerable influence on outcomes. There are no specific recommendations regarding surgeon's specialty, grade, level of skills, and experience. In conclusion, there is a weak recommendation in the guidelines on quality control in vascular access surgery. Quality assessment criteria should be defined in this field of surgery. According to these criteria, patients and nephrologists could choose the best vascular access center or surgeon. Centers with best results should be referral centers, and centers with poorer results should implement quality improvement programs.
Quality assessment of vascular access procedures for hemodialysis: A position paper of the Vascular Access Society based on the analysis of existing guidelines / B. Fila, R. Roca-Tey, J. Malik, M. Malovrh, N. Pirozzi, M. Kusztal, M. Gallieni, T. Jemcov. - In: JOURNAL OF VASCULAR ACCESS. - ISSN 1129-7298. - (2019). [Epub ahead of print]
Titolo: | Quality assessment of vascular access procedures for hemodialysis: A position paper of the Vascular Access Society based on the analysis of existing guidelines |
Autori: | |
Parole Chiave: | Hemodialysis; guidelines; quality assessment; vascular access procedures |
Settore Scientifico Disciplinare: | Settore MED/14 - Nefrologia |
Data di pubblicazione: | 2019 |
Rivista: | |
Tipologia: | Article (author) |
Data ahead of print / Data di stampa: | 19-mag-2019 |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1177/1129729819848624 |
Appare nelle tipologie: | 01 - Articolo su periodico |
File in questo prodotto:
File | Descrizione | Tipologia | Licenza | |
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FinalFila et al_Quality assessment manuscript 4_3_2018.pdf | Post-print, accepted manuscript ecc. (versione accettata dall'editore) | Open Access Visualizza/Apri | ||
Table 1. Guideline recommendations.pdf | Altro | Administrator Richiedi una copia | ||
Table 2.Characteristics of a quality VA surgeon..pdf | Altro | Administrator Richiedi una copia |