title: In preparation for a treatment guideline for suitable vascular access repair in Japan.
abstract: In cases of vascular access (VA) for hemodialysis including arteriovenous fistula and arteriovenous graft, venipuncture and hemostasis are usually repeated three times a week. Accordingly, it is assumed that VA vascular disorders are worsened following long-term hemodialysis. In particular, angiostenosis frequently occurs and results in insufficient blood flow or increased venous pressure. Additionally, stenosis is a major cause of VA occlusion. While VA intervention treatment is mainstream for VA stenosis, its major advantage lies in its less invasiveness because it is a percutaneous treatment. A further advantage of this treatment procedure is that the existing VA can be preserved intact. For practical use of VA intervention treatment, however, compliance with the therapeutic indication guideline is required. In K/DOQI of the United States, such a guideline has already been formulated based on evidence and specialist opinion, while the guideline of the European Vascular Access Society is presented in the form of a flowchart. The Japanese Society for Dialysis Therapy is currently preparing a guideline for the construction and maintenance of VA, which introduces the timing and principles of repair of VA in the following six categories: (i) stenosis; (ii) occlusion; (iii) venous hypertension; (iv) steal syndrome; (v) excess blood flow; and (vi) infection. Except for infection, most of the treatments for these events involve VA intervention, thus the need for the guideline for VA intervention treatment is becoming widely recognized.
authors.affiliation: Division of Nephrology and Blood Purification, Tenri Hospital, Nara, Japan. iamano@tenriyorozu-hp.or.jp
authors.forename: Izumi
authors.initials: I
authors.lastname: Amano
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohira
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Goto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hino
authors.forename: Kiyosi
authors.initials: K
authors.lastname: Ikeda
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kukita
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Haruguchi
mesh_terms: D000800:Angioplasty, Balloon; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy; D007564:Japan; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents