Overview of hemodialysis access and assessment

[摘要] Objective To provide family physicians with an evidence-based overview onthe various methods of vascular access for hemodialysis (HD) and to provide aframework for the clinical assessment of HD access.Sources of information A MEDLINE literature search was conducted using theMeSH terms arteriovenous fistula, arteriovenous graft, central venous catheter,and hemodialysis (or haemodialysis), including all relevant English-languagearticles published between January 1995 and September 2021.Main message The main types of permanent vascular access for HD arearteriovenous fistulas, arteriovenous grafts, and central venous catheters. Apragmatic, patient-centred approach is required when choosing the type ofaccess for an individual. Common complications of vascular access creationinclude thrombosis, central venous stenosis, dialysis access steal syndrome,and arteriovenous fistula aneurysms.Conclusion Family physicians play an important role in the clinical assessmentand monitoring of HD vascular access. A thorough clinical assessment candetect a failing arteriovenous fistula and any associated complications, whichcan allow for prompt investigation and intervention to restore functionality,maintain access longevity, and improve patient quality of life.

[学科分类] 卫生学