Dialysis access in europe and north america: are we on the same path?

Maurizio Gallieni, Ramesh Saxena, Ingemar Davidson

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Large differences in dialysis access exist between Europe, Canada, and the United States, even after adjustment for patient characteristics. Vascular access care is characterized by similar issues, but with a different magnitude. Obesity, type 2 diabetes, and peripheral vascular disease, independent predictors of central venous catheter use, are growing problems globally, which could lead to more difficulties in native arteriovenous fistula placement and survival. Creation of dedicated dialysis access teams, including a vascular access coordinator, is a fundamental step in improving vascular access care; however, it might not be sufficient. The possibility that factors other than patient characteristics and surgical skills are important in determining outcomes is likely; it might explain apparent contradictions of end-stage renal disease (ESRD) practices (kidney transplant, peritoneal dialysis, patterns of vascular access use in hemodialysis), where some countries excel in one area and score poorly in another. We are on the same path, but we have a long way to go.

Original languageEnglish (US)
Pages (from-to)96-105
Number of pages10
JournalSeminars in Interventional Radiology
Volume26
Issue number2
DOIs
StatePublished - Jun 1 2009

Keywords

  • Arteriovenous fistula
  • Catheter
  • Graft
  • Hemodialysis
  • Vascular access

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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