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Current state of dialysis access management in Korea
- Current state of dialysis access management in Korea
- Kim, Yong-Soo; Kim, Yaeni; Shin, Seok Joon; Lee, Hyung Seok; Kim, Sung Gyun; Cho, Seong; Na, Ki Ryang; Kim, Jin Kuk; Kim, Seung Jung; Kim, Young Ok; Jin, Dong-Chan; Korean Soc Diagnostic Intervention
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- JOURNAL OF VASCULAR ACCESS
- JOURNAL OF VASCULAR ACCESS vol. 20, pp. 15 - 19
- Renal replacement therapy; vascular access; peritoneal access; interventional nephrology
- SAGE PUBLICATIONS LTD
- SCIE; SCOPUS
- Document Type
- The prevalence rate and the incidence rate of hemodialysis and functioning kidney transplant recipients have continuously increased; on the contrary, those of peritoneal dialysis have continuously decreased since 2006. Dialysis patients have been getting older and have been maintained on dialysis longer. Diabetic nephropathy was the leading cause of end stage renal disease. The type of hemodialysis vascular access has been stable during the last 5 years (arteriovenous fistulas 76%, arteriovenous grafts 16%, central venous catheters 8% at 2016). Peritoneal dialysis catheter was mostly inserted surgically (67%), and swan neck straight tip peritoneal dialysis catheter was the most commonly used (48%). Vascular access was managed by radiologists and surgeons, and the management was fragmented among them in the past. However, since the nephrologists became interested in and knowledgeable about the vascular access, they began to play roles in vascular access management. Vascular access has been mostly created by vascular surgeons (approximate to 60%); tunneled central venous hemodialysis catheter insertion and endovascular intervention such as percutaneous transluminal angioplasty (PTA) and thrombectomy have been mostly performed by radiologists (approximate to 70%). Tunneled hemodialysis catheter insertion and endovascular intervention by nephrologists have slowly but consistently increased. Recently, the number of central venous hemodialysis catheter insertion has decreased, and tunneled hemodialysis catheter has been inserted more than non-tunneled hemodialysis catheter, indicating that vascular access has been created timely and the vascular access team has been educated about and following international guidelines.
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