Endovascular intervention in hemodialysis vascular access is among the most frequent interventions performed in an angiography suite. Vascular stenosis is the most prevalent lesion causing vascular access malfunction. Vascular access pathology and the outcomes in response to endovascular treatment are quite different from the arterial territory. Treatment strategy must be integrated, multidisciplinary, and with a long-term perspective, as recurrence rates of malfunction are quite common. We will detail our experience managing an extremely busy vascular access center serving a population of 4000 dialysis patients, performing all endovascular techniques in close coordination with the surgical team.
Part of the book: Cardiac Diseases
This chapter addresses three main topics (subchapters): (i) acquisition of educational skills in palliative care that are relevant to all health professionals and ways to implement these skills in the field of nephrology; (ii) ethical considerations that are applicable and support clinical and specific decisions at different stages of chronic kidney disease, such as, respect for bioethical principles in decision making related to dialysis withdrawal, effective communication with the patient and family, end of life care; and (iii) implementation and definition of key performance indicators that ensure quality of care and are patient-centred. These three (interrelated) pillars will strongly contribute to the (positive and expected) changes in the field of kidney palliative care.
Part of the book:[Working title]