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NDT Plus Advance Access originally published online on August 22, 2008
NDT Plus 2008 1(5):279-284; doi:10.1093/ndtplus/sfn136
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effect of online haemodialysis vascular access flow evaluation and pre-emptive intervention on the frequency of access thrombosis

Edwin Wijnen1, Frank M. van der Sande1, Jan H. M. Tordoir2, Jeroen P. Kooman1 and Karel M. L. Leunissen1

1 Department of Internal Medicine, Division of Nephrology
2 Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands

Correspondence: Correspondence and offprint requests to: Edwin Wijnen, Department of Internal Medicine, Division of Nephrology, University Hospital Maastricht, P. Debyelaan 25, 6202AZ Maastricht, The Netherlands. Tel: +31-43-3875007; Fax: +31-43-3875006; E-mail: edwinwijnen{at}gmail.com


  Abstract

Introduction. Guidelines advocate surveillance of vascular access to reduce incidences of thrombosis. However, the value of online vascular access flow monitoring is still under debate.

Methods. Through a systematic literature search, the effect of online access flow surveillance combined with pre-emptive intervention on thrombosis frequency is reviewed.

Results. Due to methodological differences, adequate comparison of the individual study results is not possible. Moreover, the methodological quality of most of the included studies is not suitable for an adequate statistical analysis of the results.

Conclusion. Until now, there is no conclusive evidence that online access flow evaluation has a significant effect on the rate of thrombosis. Future large-scale studies with adequate study design, adequate surveillance and intervention protocols and, possibly, better pre-emptive intervention alternative(s) are necessary.

Key Words: access survival • vascular access flow • vascular access surveillance • vascular access thrombosis • vascular access

Received for publication November 22, 2007. Accepted for publication August 1, 2008.


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