Dialysis arteriovenous access monitoring and surveillance according to the 2017 Spanish Guidelines

J Vasc Access. 2018 Sep;19(5):422-429. doi: 10.1177/1129729818761307. Epub 2018 Mar 15.

Abstract

The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access." We will analyze the current evidence on conflicting topics such as the value of the flow-based screening methods for the arteriovenous access surveillance or the role of Doppler ultrasound as the imaging exploration to confirm suspected stenosis. In addition, the concept of significant stenosis and the criteria to perform the elective intervention for stenosis were reviewed. The adoption of these guidelines will hopefully translate into a reduced risk of thrombosis and increased patency rates for both arteriovenous fistulas and grafts.

Keywords: Fistula; graft; guidelines; hemodialysis; monitoring; surveillance.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Arteriovenous Shunt, Surgical / adverse effects
  • Arteriovenous Shunt, Surgical / standards*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / standards*
  • Clinical Decision-Making
  • Graft Occlusion, Vascular / diagnostic imaging*
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Predictive Value of Tests
  • Renal Dialysis / standards*
  • Risk Factors
  • Spain
  • Thrombosis / diagnostic imaging*
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Treatment Outcome
  • Vascular Patency