Vascular and Peritoneal Access for Dialysis

When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.

Inhalt

1. Anesthesia for vascular and peritoneal access for dialysis.- I. Vascular Access for Hemodialysis.- 2. External arteriovenous shunt: The first permanent vascular access device for hemodialysis.- 3. The arteriovenous fistula.- 4. Autogenous saphenous vein grafts as vascular access for hemodialysis.- 5. Bovine heterograft and umbilical cord graft for arteriovenous fistulas.- 6. Prosthetic graft fistulas: The expanded PTFE graft.- 7. Blood access without needles: The Hemasite titanium vascular access device.- 8. Angiography for studying hemodialysis vascular access.- 9. Percutaneous femoral vessel cannulation for hemodialysis.- 10. Subclavian vein cannulation for hemodialysis.- 11. Internal jugular vein cannulation for hemodialysis.- 12. Vascular access for hemodialysis in children.- II. Peritoneal Access for Peritoneal Dialysis.- 13. The use of the disposable, stylet catheter.- 14. The permanent Tenckhoff catheters.- 15. The permanent Toronto Western Hospital catheters.- 16. Swan Neck peritoneal dialysis catheters.- 17. The choice of access for long.-term peritoneal dialysis.- 18. Dermaport® peritoneal dialysis catheter.- 19. Peritoneal access for dialysis in infants and children.- 20. Prevention of peritonitis during CAPD: Special precautions and use of connection systems.- List of Manufacturers.