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Abstract
The "Fistula Code" document has been elaborated by the Spanish Multidisciplinary Group on Vascular Access (GEMAV) in collaboration with the Spanish renal patients' associations ALCER and ADER. Similar to the "Infarction Code" and "Stroke Code", the "Fistula Code" is intended to be an urgent care protocol to identify people with renal disease treated by haemodialysis who present an acute pathology of their arteriovenous vascular access, i.e. native fistula and prosthetic fistula, in order to transfer them as quickly as possible to the Functional Vascular Access Unit or the reference hospital and carry out the treatment by surgery or endovascular procedure. Considering that thrombosis is the most frequent complication of fistula, this event will be the most frequent cause of activation of the "Fistula Code". In fact, thrombosis increases the incidence of hospitalisation, health expenditure and morbimortality of the person with renal disease, which is why the rescue of any thrombosed fistula should be an absolute priority and considered a pathology of preferential management that requires a solution as quickly as possible. The "Fistula Code" document, in addition to GEMAV, ALCER and ADER, has been agreed by the following Spanish working groups and Scientific Societies linked to the care of people with kidney disease (in alphabetical order): GEIRAS, SEACV, SEDEN, SEDYT, S.E.N. and SERVEI. Hopefully, it will soon be applied throughout Spain.
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References
- Bienvenida del Presidente. Grupo Español Multidiscipli-nar del Acceso Vascular (GEMAV) [consultado 1 Jul 2022]. Disponible en: www.gemav.org.
- Boenink R, Stel VS, Waldum-Grevbo BE, Collart F, Kersch-baum J, Heaf JG, et al. Data from the ERA-EDTA Registry were examined for trends in excess mortality in European adults on kidney replacement therapy. Kidney Int 2020; 98(4):999-1008. DOI: https://doi.org/10.1016/j.kint.2020.05.039
- Roca-Tey R. Diagnóstico precoz de la estenosis del acceso vascular para hemodiálisis mediante la determinación no invasiva del flujo sanguíneo. Tesis Doctoral. Universitat Autónoma de Barcelona, 2010. Disponible en: http://hdl.handle.net/10803/32023.
- Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Mar-tí-Monrós A, et al. Guía española del acceso vascular para hemodiálisis. Nefrologia 2017;37(Supl 1):S1–191. DOI: https://doi.org/10.1016/j.nefro.2017.11.004
- Girerd S, Girerd N, Frimat L, Holdaas H, Jardine AG, Sch-mieder RE, et al. Arteriovenous fistula thrombosis I asso-ciated with increased all-cause and cardiovascular mor-tality in haemodialysis patients from the AURORA trial. Clinical Kidney Journal 2020;13(1):116–22. DOI: https://doi.org/10.1093/ckj/sfz048
- Roca-Tey R, Ibeas J, Moreno T, Gruss E, Merino JL, Va-llespín J, et al. Behalf of the Spanish Multidisciplinary Vascular Access Group (GEMAV). Dialysis arteriovenous access monitoring and surveillance according to the 2017 Spanish guidelines. J Vasc Access 2018;19(5):422-9. DOI: https://doi.org/10.1177/1129729818761307
- Saha M, Allon M. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies. Clin J Am Soc Nephrol 2017;12:357-69. DOI: https://doi.org/10.2215/CJN.05260516
- Blake PG , Quinn RR, Oliver MJ. The risks of vascular Ac-cess. Kidney Int 2012;82:623-5. DOI: https://doi.org/10.1038/ki.2012.181
- Ellingson KD, Palekar RS, Lucero CA, Kurkjian KM, Chai SJ, Schlossberg DS, et al. Vascular access hemorrhages con-tribute to deaths among hemodialysis patients. Kidney Int 2012;82(6):686-92.Artículo en Acceso Abierto, se distribuye bajo una Licencia Creative Commons Atribución-NoComercial 4.0 Internacional.https://creativecommons.org/licenses/by-nc/4.0/. DOI: https://doi.org/10.1038/ki.2012.185
References
Bienvenida del Presidente. Grupo Español Multidiscipli-nar del Acceso Vascular (GEMAV) [consultado 1 Jul 2022]. Disponible en: www.gemav.org.
Boenink R, Stel VS, Waldum-Grevbo BE, Collart F, Kersch-baum J, Heaf JG, et al. Data from the ERA-EDTA Registry were examined for trends in excess mortality in European adults on kidney replacement therapy. Kidney Int 2020; 98(4):999-1008. DOI: https://doi.org/10.1016/j.kint.2020.05.039
Roca-Tey R. Diagnóstico precoz de la estenosis del acceso vascular para hemodiálisis mediante la determinación no invasiva del flujo sanguíneo. Tesis Doctoral. Universitat Autónoma de Barcelona, 2010. Disponible en: http://hdl.handle.net/10803/32023.
Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Mar-tí-Monrós A, et al. Guía española del acceso vascular para hemodiálisis. Nefrologia 2017;37(Supl 1):S1–191. DOI: https://doi.org/10.1016/j.nefro.2017.11.004
Girerd S, Girerd N, Frimat L, Holdaas H, Jardine AG, Sch-mieder RE, et al. Arteriovenous fistula thrombosis I asso-ciated with increased all-cause and cardiovascular mor-tality in haemodialysis patients from the AURORA trial. Clinical Kidney Journal 2020;13(1):116–22. DOI: https://doi.org/10.1093/ckj/sfz048
Roca-Tey R, Ibeas J, Moreno T, Gruss E, Merino JL, Va-llespín J, et al. Behalf of the Spanish Multidisciplinary Vascular Access Group (GEMAV). Dialysis arteriovenous access monitoring and surveillance according to the 2017 Spanish guidelines. J Vasc Access 2018;19(5):422-9. DOI: https://doi.org/10.1177/1129729818761307
Saha M, Allon M. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies. Clin J Am Soc Nephrol 2017;12:357-69. DOI: https://doi.org/10.2215/CJN.05260516
Blake PG , Quinn RR, Oliver MJ. The risks of vascular Ac-cess. Kidney Int 2012;82:623-5. DOI: https://doi.org/10.1038/ki.2012.181
Ellingson KD, Palekar RS, Lucero CA, Kurkjian KM, Chai SJ, Schlossberg DS, et al. Vascular access hemorrhages con-tribute to deaths among hemodialysis patients. Kidney Int 2012;82(6):686-92.Artículo en Acceso Abierto, se distribuye bajo una Licencia Creative Commons Atribución-NoComercial 4.0 Internacional.https://creativecommons.org/licenses/by-nc/4.0/. DOI: https://doi.org/10.1038/ki.2012.185