Abstract:
The growing number of prevalent arteriovenous (AV) accesses has been associated with an increase in the incidence of procedures being performed to maintain patency. To reduce the rate of unnecessary procedures, the 2019 Kidney Disease Outcome Quality Initiative guidelines addended the AV access surveillance recommendations, which includes clinical monitoring and assessment of dialysis adequacy alone. Abnormal clinical findings would necessitate follow-up angiography with or without confirmatory duplex ultrasound. Due to poor patency, increased surveillance schedules have been proposed to identify stenosis early and potentially prevent acute thrombotic events and AV access failure. In this review, we outlined current AV access monitoring and maintenance procedure recommendations, as described by the Centers for Medicare and Medicaid Services and 2019 Kidney Disease Outcome Quality Initiative guidelines. In addition, we highlight the findings of recently published randomized controlled trials that have examined increased surveillance schedules.
摘要:
越来越多的普遍的动静脉(AV)通路与为维持通畅而进行的手术的发生率增加有关。为了减少不必要的程序,2019年肾脏疾病结局质量倡议指南增加了AV访问监测建议,其中包括仅对透析充分性进行临床监测和评估。异常的临床发现将需要有或没有证实的双工超声的随访血管造影。由于通畅性差,已提出增加的监测时间表,以及早发现狭窄,并有可能预防急性血栓事件和房室通路衰竭.在这次审查中,我们概述了当前的AV访问监控和维护程序建议,如医疗保险和医疗补助服务中心和2019年肾脏疾病结局质量倡议指南所述。此外,我们重点介绍了最近发表的随机对照试验的结果,这些试验检查了增加的监测时间表。