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Hemodialysis vascular access morbidity.

H I Feldman, S Kobrin and A Wasserstein
JASN April 1996, 7 (4) 523-535;
H I Feldman
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S Kobrin
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A Wasserstein
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Abstract

Complications associated with hemodialysis vascular access represent one of the most important sources of morbidity among ESRD patients in the United States today. In this study, new data on the magnitude and growth of vascular access-related hospitalization in the United States is presented, demonstrating that the costs of this morbidity will soon exceed $1 billion per yr. This study also reviews published literature on the morbidity associated specifically with native arteriovenous fistulae, polytetrafluoroethylene bridge grafts, and permanent central venous catheters. Next, new information on the changing patterns of vascular access type in the United States is presented, demonstrating the continuing evolution of medical practice away from the use of arteriovenous fistulae in favor of more reliance on synthetic bridge grafts. Based on these data, a discussion is provided of the tradeoffs among the most commonly available modalities of vascular access today. Although radial arteriovenous fistulae continue to represent the optimal access modality, the appropriate roles for brachial arteriovenous fistulae, synthetic bridge grafts, and central venous catheters are less certain because of inadequate data on the long-term function of the first and the high rates of complications associated with the latter two. To reduce vascular access-related morbidity, strategies must be developed not only to prevent and detect appropriately early synthetic vascular access dysfunction, but to better identify the patients in a whom radial arteriovenous fistula is a viable clinical option.

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Journal of the American Society of Nephrology
Vol. 7, Issue 4
1 Apr 1996
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Hemodialysis vascular access morbidity.
H I Feldman, S Kobrin, A Wasserstein
JASN Apr 1996, 7 (4) 523-535;

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Hemodialysis vascular access morbidity.
H I Feldman, S Kobrin, A Wasserstein
JASN Apr 1996, 7 (4) 523-535;
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Cited By...

  • Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study
  • The Clinical and Economic Effect of Vascular Access Selection in Patients Initiating Hemodialysis with a Catheter
  • Association of vascular access flow with short-term and long-term mortality in chronic haemodialysis patients: a retrospective cohort study
  • Provider Visit Frequency and Vascular Access Interventions in Hemodialysis
  • In Vivo Nanoparticle Assessment of Pathological Endothelium Predicts the Development of Inflow Stenosis in Murine Arteriovenous Fistula
  • Novel Paradigms for Dialysis Vascular Access: Downstream Vascular Biology-Is There a Final Common Pathway?
  • Candidate Gene Analysis of Arteriovenous Fistula Failure in Hemodialysis Patients
  • Thrombophilia and Arteriovenous Fistula Survival in ESRD
  • Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts
  • Decreased Cumulative Access Survival in Arteriovenous Fistulas Requiring Interventions to Promote Maturation
  • Risk Factors Associated with Patency Loss of Hemodialysis Vascular Access within 6 Months
  • Arteriovenous Fistulas among Incident Hemodialysis Patients in Department of Defense and Veterans Affairs Facilities
  • Statin Therapy Is Not Associated with Improved Vascular Access Outcomes
  • A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of Tenecteplase for Improvement of Hemodialysis Catheter Function: TROPICS 3
  • Antiplatelet Medications in Hemodialysis Patients: A Systematic Review of Bleeding Rates
  • Improved treatment feasibility in children with hemophilia using arteriovenous fistulae: the results after seven years of follow-up
  • Plasma ADMA Predicts Restenosis of Arteriovenous Fistula
  • Significant Correlation between Ankle-Brachial Index and Vascular Access Failure in Hemodialysis Patients
  • Stent Placement Versus Angioplasty Improves Patency of Arteriovenous Grafts and Blood Flow of Arteriovenous Fistulae
  • Far Infrared Therapy Inhibits Vascular Endothelial Inflammation via the Induction of Heme Oxygenase-1
  • Fistula First Initiative: Advantages and Pitfalls
  • Far-Infrared Therapy: A Novel Treatment to Improve Access Blood Flow and Unassisted Patency of Arteriovenous Fistula in Hemodialysis Patients
  • The risk of dialysis access thrombosis is related to the transforming growth factor-beta1 production haplotype and is modified by polymorphisms in the plasminogen activator inhibitor-type 1 gene
  • Associations between Demographic Factors and Provider Structures on Cost and Length of Stay for Hemodialysis Patients with Vascular Access Failure
  • Hemodialysis Vascular Access Dysfunction: A Cellular and Molecular Viewpoint
  • Adenovirus-Mediated Expression of {beta}-Adrenergic Receptor Kinase C-Terminus Reduces Intimal Hyperplasia and Luminal Stenosis of Arteriovenous Polytetrafluoroethylene Grafts in Pigs
  • Thrombophilia and the Risk for Hemodialysis Vascular Access Thrombosis
  • Variable Pump Flow-Based Doppler Ultrasound Method: A Novel Approach to the Measurement of Access Flow in Hemodialysis Patients
  • Establishment and Maintenance of Vascular Access in Incident Hemodialysis Patients: A Prospective Cost Analysis
  • Regular Monitoring of Access Flow Compared with Monitoring of Venous Pressure Fails to Improve Graft Survival
  • Coagulation: Consultative Hemostasis
  • Reduction in Vascular Lesion Formation by Hirudin Secreted From Retrovirus-Transduced Confluent Endothelial Cells on Vascular Grafts in Baboons
  • Plasma Total Homocysteine and Hemodialysis Access Thrombosis: AProspective Study
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