Vascular access creation and maintenance in the USA.
Exponential growth and increasing longevity of end-stage renal disease (ESRD) has resulted in significant ongoing changes in vascular access (VA) planning and management in the United States. There is a positive trend showing an increase in arteriovenous fistula (AVF) prevalence both in incident and prevalent patients and a decrease in tunneled dialysis catheters (TDCs) in prevalent patients. Current surgical training seems to provide adequate exposure to VA and an ample opportunity to develop skills required for safe surgical placement of VA. The prevalent differences in practice patterns suggest a need for standardization of VA care. There is a need for a structured curriculum in VA, which is a critical component in making sound decisions in access planning and management.
1 Section of Transplantation, Washington University School of Medicine, Saint Louis - USA.
Neeta
N
Vachharajani
Paul
P
Wise
Mary
M
Klingensmith
David
D
Jaques
Surendra
S
Shenoy
D001166:Arteriovenous Shunt, Surgical / Q000193:education / Q000592:standards / Q000639:trends*; D002405:Catheterization, Central Venous / Q000592:standards / Q000639:trends*; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends*; D004503:Education, Medical, Graduate / Q000639:trends; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D015995:Prevalence; D058996:Quality Improvement / Q000639:trends; D019984:Quality Indicators, Health Care / Q000639:trends; D006435:Renal Dialysis / Q000592:standards / Q000639:trends*; D014481:United States / Q000453:epidemiology