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Recommended standards for reports dealing with arteriovenous hemodialysis accesses
Anton N Sidawy1, Richard Gray, Anatole Besarab
1Committee on Reporting Standards for Arterio-Venous Accesses of The Society for Vascular Surgery and the American Association for Vascular Surgery, Washington, DC, USA.
Insights
Standardized reporting for arteriovenous hemodialysis access (AV access) is needed due to high complication rates and difficulty comparing outcomes. This document provides definitions and standards for AV access procedures to improve data consistency.
Area of Science:
- Nephrology
- Vascular Surgery
- Medical Device Reporting
Background:
- End-stage renal disease (ESRD) incidence is rising, increasing demand for hemodialysis access.
- Arteriovenous (AV) access creation and maintenance are critical yet challenging aspects of ESRD management.
- High complication rates (33-99% in 1 year) and varied reporting methods hinder outcome comparisons for AV access.
Purpose of the Study:
- To establish standardized definitions for AV access procedures.
- To recommend reporting standards for AV access patency and complications.
- To enable meaningful comparisons of AV access outcomes across different studies and institutions.
Main Methods:
- Development of standardized terms and definitions for AV access procedures.
- Recommendation of specific reporting standards for patency and complications.
- Approval of definitions and standards by the Society for Vascular Surgery and American Association for Vascular Surgery Committee on Reporting Standards.
Main Results:
- A framework for standardized reporting of AV access procedures is proposed.
- Standardized definitions facilitate consistent data collection and analysis.
- The recommendations aim to improve the quality of research and clinical practice in AV access.
Conclusions:
- Standardized reporting is essential for comparing AV access outcomes and improving patient care.
- The proposed standards will aid surgeons, nephrologists, and interventional radiologists in consistent reporting.
- Adherence to these standards is recommended for manuscripts submitted to the Journal of Vascular Surgery.
Abstract:
The incidence rate of treated end-stage renal disease in the united states is 180 per million and continues to rise at a rate of 7.8% per year. Arteriovenous hemodialysis access (AV access) creation and maintenance are two of the most difficult issues associated with the management of patients on hemodialysis. The 1-year complication rate of a primary prosthetic AV access for hemodialysis ranges from 33% to 99%. Various investigators report on patency and complications of AV access. However, it is rather difficult to compare outcomes because of the wide variety of access materials, configurations, locations, risk factors, and quality of inflow and outflow vessels. Although there have been reporting standards for dialysis access endovascular interventions and for central venous access placement, standards regarding surgical access placement and its revision are lacking. The "Dialysis Outcome Quality Initiative," published by the National Kidney Foundation, provides recommendations for optimal clinical practices aimed at improving dialysis outcome and patient survival. This reporting standards document is not meant to be a "practice guidelines" or "best practices" document. Rather, the purpose of this document is to provide standardized definitions related to AV access procedures and to recommend reporting standards for patency and complications, to be used by surgeons, nephrologists, and interventional radiologists, that will permit meaningful comparisons among AV access procedures. The terms, definitions, and categories featured in this article have been approved by the Committee on Reporting Standards of the Society for Vascular Surgery and the American Association for Vascular Surgery and should be observed in preparing manuscripts on AV accesses for submission to the Journal Of Vascular Surgery.