This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Renal Diseases  • Dialysis  • Renal Diseases, Other  • Statistics and Research Methods  • Prognosis/ Outcomes  • Drug Therapy  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Time to Step Up to the Plate

Marcello Tonelli, MD, SM, FRCPC

JAMA. 2008;299(18):2205-2207.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Hemodialysis requires a reliable conduit to transport blood from the patient to the dialysis apparatus and back again, which is usually termed "vascular access." Establishing and maintaining vascular access is time-consuming, difficult, and expensive—access creation and complications are the most common causes of hospital admissions in patients with end-stage renal disease,¹ at an estimated annual cost of more than $1 billion in the United States alone.² Accordingly, vascular access has been termed the "Achilles' heel" of hemodialysis.³

Current options for vascular access include central venous catheters, synthetic grafts, and native vessel arteriovenous fistulas. Once established, arteriovenous fistulas are associated with the best clinical outcomes and the lowest costs.^4-10 However, unlike catheters and grafts, a substantial proportion of arteriovenous fistulas never mature sufficiently to be used for hemodialysis treatment, which is a major barrier to increasing the prevalence of their use. Although failure of arteriovenous fistulas . . . [Full Text of this Article]

Author Affiliations: Alberta Kidney Disease Network and Department of Critical Care, University of Alberta, Edmonton, and Institute of Health Economics, Edmonton, Alberta, Canada.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Effect of Clopidogrel on Early Failure of Arteriovenous Fistulas for Hemodialysis: A Randomized Controlled Trial
Laura M. Dember, Gerald J. Beck, Michael Allon, James A. Delmez, Bradley S. Dixon, Arthur Greenberg, Jonathan Himmelfarb, Miguel A. Vazquez, Jennifer J. Gassman, Tom Greene, Milena K. Radeva, Gregory L. Braden, T. Alp Ikizler, Michael V. Rocco, Ingemar J. Davidson, James S. Kaufman, Catherine M. Meyers, John W. Kusek, Harold I. Feldman, and for the Dialysis Access Consortium Study Group
JAMA. 2008;299(18):2164-2171.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effect of Clopidogrel on Arteriovenous Fistulas for Dialysis
Fourtounas and Vlachojannis
JAMA 2008;300:1648-1648.
FULL TEXT