surveillance and monitoring of dialysis access监测和监测透析访问.pdfVIP

Hindawi Publishing Corporation International Journal of Nephrology Volume 2012, Article ID 649735, 9 pages doi:10.1155/2012/649735 Review Article Surveillance and Monitoring of Dialysis Access Lalathaksha Kumbar, Jariatul Karim, and Anatole Besarab Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI 48202, USA Correspondence should be addressed to Lalathaksha Kumbar, lkumbar1@ Received 4 September 2011; Accepted 4 October 2011 Academic Editor: Alexander Yevzlin Copyright © 2012 Lalathaksha Kumbar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Vascular access is the lifeline of a hemodialysis patient. Currently arteriovenous fistula and graft are considered the permanent options for vascular access. Monitoring and surveillance of vascular access are an integral part of the care of hemodialysis patient. Although different techniques and methods are available for identifying access dysfunction, the scientific evidence for the optimal methodology is lacking. A small number of randomized controlled trials have been performed evaluating different surveillance techniques. We performed a study of the recent literature published in the PUBMED, to review the scientific evidence on different methodologies currently being used for surveillance and monitoring and their impact on the care of the dialysis access. The limited randomized studies especially involving fistulae and small sample size of the published studies with conflicting results highlight the need for a larger multicentered randomized study with hard clinical end points to evaluate the optimal surveillance strategy for both