Hemodialysis access monitoring and surveillance- how and why?
Summary of "Hemodialysis access monitoring and surveillance- how and why?"
Hemodialysis access is the 'life line' for patients on renal replacement therapy. Vascular access failure and complications are the second leading cause for hospitalization of patients on hemodialysis. The concept of access monitoring is based on the basic tenet that identification of patients at risk of developing future access failure, coupled with elective intervention will decrease the incidence of hemodialysis access failure and improve patient outcomes. Clinical monitoring and surveillance techniques are very effective in detecting hemodialysis access lesions. However, the studies analyzing the impact of monitoring and surveillance have yielded a variety of controversial results, which is likely the result of the differences in methodology and use of a variety of parameters. Despite the controversy surrounding the value of monitoring and surveillance, the Conditions of Coverage for dialysis providers mandate monitoring with appropriate and timely referrals to achieve and sustain vascular access. This review discusses pros and cons of various monitoring and surveillance techniques and suggests a strategy based on current literature.
Department of Medicine, Nephrology Division, The Ohio State University Medical Center, Columbus, Ohio.
This article was published in the following journal.
Name: Frontiers in bioscience (Elite edition)
Medical and Biotech [MESH] Definitions
Hemodialysis Units, Hospital
Hospital units in which care is provided the hemodialysis patient. This includes hemodialysis centers in hospitals.
Product Surveillance, Postmarketing
Surveillance of drugs, devices, appliances, etc., for efficacy or adverse effects, after they have been released for general sale.
Physiologic or biochemical monitoring of the fetus. It is usually done during LABOR, OBSTETRIC and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery.
Long-term maintenance hemodialysis in the home.
Monitoring of rate of occurrence of specific conditions to assess the stability or change in health levels of a population. It is also the study of disease rates in a specific cohort, geographic area, population subgroup, etc. to estimate trends in larger population. (From Last, Dictionary of Epidemiology, 2d ed)
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