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Int J Artif Organs. 2009 Dec;32(12):851-6.

Dialysis access: an increasingly important clinical issue.

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1
Nephrology and Dialysis Unit, San Carlo Borromeo Hospital, Milan, Italy. gallieni.maurizio@sancarlo.mi.it

Abstract

Dialysis access, including vascular access for hemodialysis and peritoneal access for peritoneal dialysis, is critical in the clinical care of patients with end-stage renal disease. It is associated with increases in morbidity, mortality, and health care costs. A number of problematic issues are involved, some of which are addressed in this paper with reference to the most recent publications, including: the inappropriately low prevalence of peritoneal dialysis in Western countries, which is relevant to access placement in the pre-dialysis stage; the excessively high use of central venous catheters in incident and prevalent dialysis patients; the diagnosis and treatment of steal syndrome; the advantages and limitations of antiplatelet therapy; and finally, the correct pre-operative evaluation and subsequent surveillance of the vascular access.

PMID:
20037889
[Indexed for MEDLINE]
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