대한신장학회

논문분류	춘계학술대회 초록집
제목	How to Overcome AV Access Thrombotic Flow-Related Complications
저자	Jin Ho Lee
출판정보	2022; 2022(1):
키워드
초록	Blood flow-related complications of vascular access have long been a major obstacle to maintaining the health of hemodialysis patients. Vascular access that require high blood flow for dialysis cause continuous turbulent flow, which causes intimal hyperplasia in the blood vessels, which causes stenosis of blood vessels. Blood flow-related complications of vascular access are commonly observed, and the lifespan of blood vessels is shortened due to stenosis and thrombosis, and it is also associated with a decrease in the patient's quality of life or a decrease in survival rate. Although various treatments and preventive methods have been proposed to overcome blood flow-related complications, the most important treatment currently is percutaneous transluminal angioplasty(PTA). The balloon catheter increases the diameter by applying various pressures to the vascular access with stenosis, which improves blood flow and dialysis is performed properly. However, this is a double-edged sword, and the balloon dilatation treatment itself causes injury to the intima of the dialysis vessels, so it should be used with caution and only when absolutely necessary. Indiscriminate PTA treatment causes an increase in national treatment costs and causes problems such as increased medical costs and pain due to unnecessary procedures for patients. The 2019 KDOQI guidelines further emphasized the clinical indicator. In particular, if there is no problem in dialysis and there is no abnormality in the physical examination, it is recommended not to perform additional balloon dilatation (Do nothing). However, if the treatment of dialysis vessel stenosis is delayed after the clinical indicator has occurred, thrombosis occurs, which is related to a decrease in the success rate of rescue treatment and greater pain and cost. Dialysis clinic medical staff should continuously observe vascular access before and after every dialysis session, educate patients to be interested in dialysis vessels, and treat vascular access stenosis that has a clinical indicator as soon as possible through PTA. Blood flow-related complications of vascular access can be well prevented with the constant attention and examination of the dialysis clinic, and at this time, patients will receive more successful dialysis treatment, which will reduce stress for patients, their guardians, and the dialysis clinic medical staff.
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