TY - JOUR
T1 - KDOQI Clinical Practice Guideline for Vascular Access
T2 - 2019 Update
AU - National Kidney Foundation
AU - Lok, Charmaine E.
AU - Huber, Thomas S.
AU - Lee, Timmy
AU - Shenoy, Surendra
AU - Yevzlin, Alexander S.
AU - Abreo, Kenneth
AU - Allon, Michael
AU - Asif, Arif
AU - Astor, Brad C.
AU - Glickman, Marc H.
AU - Graham, Janet
AU - Moist, Louise M.
AU - Rajan, Dheeraj K.
AU - Roberts, Cynthia
AU - Vachharajani, Tushar J.
AU - Valentini, Rudolph P.
N1 - Funding Information:
All dressing material should be applied using no-touch or aseptic techniques. No-touch technique means that all open ports and ends of CVCs are not touched with hands or gloves (see http://antt.org/ANTT_Site/home.html ). Recent data indicate that there is no significant difference between transparent, semipermeable dressings, and standard gauze dressings with respect to CVC exit site colonization or CRBSI. 337-339 This is also supported by the ERT. For example, 1 small RCT (n = 66) compared 2 dressings: a sterile transparent film and a traditional sterile gauze and hypoallergenic micropore dressing. 340 No significant difference in CVC-related infection (12% intervention, 9% control; P = 0.69) was found. 340
Funding Information:
Dr Lee is Professor of Medicine in the Department of Medicine and Division of Nephrology, with a secondary appointment in the Department of Biomedical Engineering at the University of Alabama at Birmingham. He received his medical degree from the Louisiana State University Health Sciences Center in Shreveport and completed his Internal Medicine residency and Nephrology fellowship at the University of Alabama at Birmingham, Nephrology research fellowship at the University of Alabama at Birmingham, and Masters of Science in Public Health degree at the University of Alabama at Birmingham. Dr Lee currently serves as the Associate Director of Interventional Nephrology, Associate Nephrology Fellowship Director, Associate Director of the Nephrology Research Training Center, Associate Section Chief, and Director of the Hemodialysis Program at the Birmingham Veterans Affairs Medical Center. He has been involved in hemodialysis vascular access research since 2002 and has more than 50 publications in vascular access research. He has active research programs in clinical trials and large epidemiologic studies in dialysis vascular access and a laboratory-based translational research program in dialysis vascular access studying human vascular access blood vessel tissue biorepositories and mechanisms of arteriovenous fistula dysfunction using animal models (mouse, rat, and pig). The goal of his research program is to develop novel therapeutics to prevent and treat complications of hemodialysis vascular access dysfunction and improve the delivery and processes of care for patients requiring a hemodialysis vascular access. Dr Lee’s research program is currently funded by the National Institutes of Health and Veterans Affairs Medical Center. He serves a counselor in the American Society of Diagnostic and Interventional Nephrology. Dr. Lee served as a consultant for Merck Sharp & Dohme Corporation (2017, 2019) and Boston Scientific (2019).
Publisher Copyright:
© 2019
PY - 2020/4
Y1 - 2020/4
N2 - The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for hemodialysis vascular access since 1996. Since the last update in 2006, there has been a great accumulation of new evidence and sophistication in the guidelines process. The 2019 update to the KDOQI Clinical Practice Guideline for Vascular Access is a comprehensive document intended to assist multidisciplinary practitioners care for chronic kidney disease patients and their vascular access. New topics include the end-stage kidney disease “Life-Plan” and related concepts, guidance on vascular access choice, new targets for arteriovenous access (fistulas and grafts) and central venous catheters, management of specific complications, and renewed approaches to some older topics. Appraisal of the quality of the evidence was independently conducted by using a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and interpretation and application followed the GRADE Evidence to Decision frameworks. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.
AB - The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for hemodialysis vascular access since 1996. Since the last update in 2006, there has been a great accumulation of new evidence and sophistication in the guidelines process. The 2019 update to the KDOQI Clinical Practice Guideline for Vascular Access is a comprehensive document intended to assist multidisciplinary practitioners care for chronic kidney disease patients and their vascular access. New topics include the end-stage kidney disease “Life-Plan” and related concepts, guidance on vascular access choice, new targets for arteriovenous access (fistulas and grafts) and central venous catheters, management of specific complications, and renewed approaches to some older topics. Appraisal of the quality of the evidence was independently conducted by using a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and interpretation and application followed the GRADE Evidence to Decision frameworks. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.
UR - http://www.scopus.com/inward/record.url?scp=85081230440&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2019.12.001
DO - 10.1053/j.ajkd.2019.12.001
M3 - Article
C2 - 32778223
AN - SCOPUS:85081230440
SN - 0272-6386
VL - 75
SP - S1-S164
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4
ER -