PDI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Perit Dial Int 28(6): 585-590
2008
© 2008 International Society for Peritoneal Dialysis
This Article
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Google Scholar
Right arrow Articles by Chiarelli, G.
Right arrow Articles by Gallieni, M.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chiarelli, G.
Right arrow Articles by Gallieni, M.

CONTROVERSIES IN PERITONEAL DIALYSIS

VASCULAR ACCESS PLANNING IN PERITONEAL DIALYSIS PATIENTS

Giusy Chiarelli1,2, Monica Beaulieu2, Mario Cozzolino1, Suneet Singh2, Mercedeh Kiaii2, Paul Taylor2, Adeera Levin2, Diego Brancaccio1 and Maurizio Gallieni1

Nephrology and Dialysis Unit,1 San Paolo Hospital, University of Milan, Italy; Division of Nephrology,2 University of British Columbia, Vancouver, British Columbia, Canada

Correspondence to: G. Chiarelli, Renal Division, San Paolo Hospital, Via Di Rudini 8, 20142 Milan, Italy. giusychiarelli{at}yahoo.it

Peritoneal dialysis (PD) is a well-established renal replacement therapy for end-stage renal disease patients. Nonetheless, on an annual basis, at least 10% of patients shift from PD to hemodialysis for a variety of reasons. Thus the issue of vascular access creation needs to be addressed for this small but significant group of patients. Despite the relatively consistent number of dropouts, the creation of an arteriovenous fistula prior to transfer remains suboptimal, and variable from center to center. Literature for this specific area is poor and dated. Guidelines seem to suggest vascular access creation in high-risk failure patients, but they have no detailed criteria to select patients that would likely fail PD and therefore take advantage of a backup access. There is a need to better understand and predict patients that require conversion to hemodialysis to develop a plan that focuses on wellness and maximum quality of life in the lifecycle of PD patients. This review addresses the issue of vascular access planning in adult PD patients, presents the available literature on the topic and the current guidelines and recommendations, and describes a research agenda to guide decision making in clinical practice.

KEY WORDS: Renal replacement therapy; vascular access; dropout; technique failure; arteriovenous fistula.

Received 20 September 2007; accepted 18 April 2008.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Multimed Inc. logo
Copyright © 2008 by Multimed Inc.