[Preservation of vascular and cardiac capital in the patient with chronic kidney failure].
Preservation of the vascular and cardiac capital is an essential objective at all times in patients with chronic renal failure, even before end-stage renal failure, at which time the urologist may need to perform surgical procedures on the urinary tract in the presence of uropathy. Medical and paramedical teams must be aware of the importance of preservation of the capital venous of the upper extremity and the risks of subclavian catheterization at this stage. When creating a vascular access, distal anastomoses should be preferred, sometimes at the cost of grafting, in order to preserve left ventricular function. Close collaboration with radiologists is now essential to manage complications of vascular accesses. The management of arteriovenous fistula after transplantation depends on many sometimes contradictory parameters and should be determined case by case. The importance of "economic" management of the patient's vascular and cardiac capital justifies global management of chronic renal failure by urologists perfectly familiar with the specific problems of these patients and trained to intervene throughout the course of the disease.
Barrou
B
B
Service d'Urologie, Groupe Hospitalier Pitié-Salpêtrière, Paris. benoit.barrou@psl.ap-hop-paris.fr
Cluzel
P
P
Bitker
M O
MO
Hamadi
A
A
Jacobs
C
C
Richard
F
F
D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008991:Monitoring, Physiologic; D006435:Renal Dialysis / Q000379:methods*