A review of hemodialysis vascular access devices: improving client outcomes through evidence-based practice

The number of clients with end-stage renal disease and acute kidney injury requiring kidney replacement therapy is at an all-time high. At the end of 2010, the number of persons in the United States with end-stage renal disease totaled 594,374. Because the majority of clients select hemodialysis, understanding best-practice techniques to prevent infection is paramount. The purpose of this article is to review best-practice recommendations for care of the 3 major vascular access devices used for hemodialysis, with a particular focus on infection prevention recommendations. Implications for infusion nurses are also discussed.