Revolutionize Your Approach to Vascular Access Surveillance

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INDICATIONS, SAFETY AND WARNINGS

Vascular access failure is one of the causes of hospitalization in dialysis patients, and access thrombosis is a leading cause of loss of access patency.¹ In addition, vascular access complications can contribute to as much as 25% of all dialysis patient hospitalizations per annum with the vast majority due to thrombosis.^1,2 Vascular access dysfunction is also costly, with vascular access care estimates reported at $1.8 billion annually.³

A vascular access surveillance program provides information clinicians can use to extend the lifespan of the vascular access through planning, coordination and elective corrective intervention. Such a program may reduce the frequency of urgent procedures resulting in the need for catheters or hospitalizations. According to KDOQI Clinical Practice Guidelines,⁴ “It has been shown that an aggressive policy for monitoring hemodynamics within AVG or AVF to detect access dysfunction may reduce the rate of thrombosis.”¹

An effective surveillance program may allow the early detection of patient access dysfunction before the patient develops complications. Coupled with a program of elective stenosis correction, access thrombosis rates decline approximately 50-75%.⁴

Vascular access dysfunction may lead to patients being under-dialyzed, resulting in lower Kt/V and an increase in morbidity and mortality. Every 0.1 decrease in Kt/V is associated with 11% more hospitalizations and 12% more hospital days.¹

Through routine and consistent use of a vascular access surveillance program, staff may easily identify access dysfunction through a combination of physical assessment and intradialytic monitoring. A simple way to implement such a program is using the 2008® series hemodialysis machines with Access Flow feature and the CombiSet® True Flow bloodline with Twister device.

References

1. National Kidney Foundation, “NKF K/DOQI Guidelines: Clinical Practice Guidelines and Recommendations, 2006 Updates Hemodialysis Adequacy, Peritoneal Adequacy, Vascular Access.” Available: here. Pages 241-242, 273-301.

2. Rios, Danyelle et al, “Hemodialysis Vascular Access Thrombosis: The Role of Factor V Leiden, Prothrombin Gene Mutation and ABO Blood Group.” Clinica Chimica Acta, 412 (2011): 425-429.

3. Chang et al, “Intradialytic Hypotension and Vascular Access Thrombosis”. Journal of the American Society of Nephrology, 8 (2011): 1526-1533.

4. Sands, Jeffery, “Vascular Access Monitoring Improves Outcomes”. Blood Purification, 23 (2005): 45-49

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