title: Time to move away from damage control strategy in hemodialysis vascular access management: a view from Saudi Arabia.
abstract: For the last 40 years, most of the research and publications on hemodialysis access, has focused on the management of its complications e.g. thrombosis, infection, aneurysms. In other words, a damage control strategy. While this is undoubtedly an important part of access management, it is a deficient reactive strategy that does not enhance a better quality of life for patients or help reduce the burden on health care resources. To achieve these objectives, efforts should be directed at ways which provide a longer access life with fewer complications. Such an approach would save costs and reduce the suffering of the patient. In this paper we will focus on hemodialysis management in Saudi Arabia, describe the reasons for the current unsatisfactory situation, and highlight possible remedies.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia. alwahbi1@hotmail.com
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Wahbi
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000191:economics / Q000592:standards; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000191:economics / Q000592:standards; D002908:Chronic Disease; D019983:Guideline Adherence; D017048:Health Care Costs; D006297:Health Services Accessibility; D006801:Humans; D007674:Kidney Diseases / Q000191:economics / Q000628:therapy*; D016030:Kidney Transplantation; D010043:Outcome and Process Assessment, Health Care / Q000191:economics / Q000592:standards; D010342:Patient Acceptance of Health Care; D010530:Peritoneal Dialysis; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D011788:Quality of Life; D012017:Referral and Consultation; D006435:Renal Dialysis / Q000191:economics / Q000592:standards; D012529:Saudi Arabia