Renal failure patients how to avoid dialysis(2)

Author: Leo and Lucy
Keywords: kidney disease | dialysis

From google images

Kidney disease is a chronic developmental disease, also known as "gentle killer", early difficult to find, clinical symptoms are not obvious, most of the patients with renal disease damage to a certain extent after the discovery, especially for renal dysfunction Patients, the best treatment time has been missed, but the renal function is in a rapid state of progress, if the treatment is not timely, will soon lead to renal failure, and ultimately to be dialysis or kidney transplantation treatment. So how to make this part of the kidney disease patients through active treatment, try to avoid dialysis, which is what we all concerned about.
Hemodialysis of vascular access
Ideal for vascular access
1 plenty of blood flow
2 is easy to use and can be used repeatedly
3 less stable and stable complications
Vascular access standards
⊙ dialysis flow to 200 ~ 500ml / min, autologous arteriovenous fistula natural blood flow 500 ~ 1500ml / min;
⊙ safe;
⊙ rapid: especially refers to the temporary vascular access;
⊙ as far as possible not to waste blood vessels, do not cause ischemia, do not increase the burden on the heart;
⊙ long-term patency rate, especially refers to the permanent vascular access;
⊙ try not to affect the patient activity;
⊙ subcutaneous arteriovenous fistula requires sufficient puncture part.
Classification of blood purification pathways
1, temporary vascular access
Methods include: arteriovenous direct puncture, central venous catheter, arteriovenous fistula.
2, long-term vascular access
Methods include: autologous arteriovenous fistula, artificial vascular fistula, long-term central venous catheter.
The advantages and disadvantages of various vascular access
Autologous fistula
Advantages: high patency rate, less complications, low cost, long service life
Transplanted fistula
Advantages: large flow, easy to use, less infection.
Long-term catheter
Advantages: the use of early, suitable for low blood pressure.
Autologous fistula
Disadvantages: heavy heart burden, not suitable for low blood pressure, vascular conditions limitations
Transplanted fistula
Disadvantages: short life expectancy, high cost of heavy heart burden.
Long-term catheter
Disadvantages: more infections, thrombosis, may lead to central venous thrombosis.
Temporary vascular access indications and long-term indwelling catheter indications
Temporary vascular access indications
1, acute renal failure;
2, the end of chronic renal failure, permanent path before immature, need emergency dialysis;
3, acute deterioration of renal failure need to do temporary dialysis to improve the situation;
4, fistula loss function or temporarily can not be used, need to rebuild or modify;
5, other reasons need temporary blood purification treatment: such as poisoning and so on.
Long-term indwelling catheter indications
1, long fistula is not yet mature and eager to hemodialysis patients
2, can not establish fistula and can not carry out kidney transplant patients;
3, kidney transplant money in patients with transitional period;
4, patients with severe arterial disease;
5, low blood pressure can not maintain fistula blood flow in patients;
6, heart failure can not tolerate the fistula patients.

With the diabetes, hypertension and other diseases continue to increase the incidence of vascular lesions already exist to the establishment of vascular access to bring new challenges. Regardless of the choice of the kind of vascular access, we must clear the powerful relationship, it is necessary to protect the blood vessels, heart, but also to achieve adequate dialysis standards, choose their own vascular access.

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