Creación del acceso vascular en el paciente que ha de iniciar hemodiálisis

20 de enero de 2021 |
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Creación del acceso vascular en el paciente que ha de iniciar hemodiálisis


Según diversas Guías clínicas publicadas, la fístula arteriovenosa nativa (FAVn) debe considerarse como la primera opción en la mayoría de los casos por delante de la fístula arteriovenosa protésica (FAVp) y del catéter venoso central (CVC) en el momento de seleccionar el acceso vascular (AV) idóneo para iniciar el programa de hemodiálisis (HD) crónica. Algunas Guías clínicas también distinguen entre catéter venoso tunelizado (CVT) y no tunelizado (CVNT) como «tercera opción» y «elección de necesidad», respectivamente.

Siguiendo este orden de preferencia, la situación actual en la mayoría de los países industrializados dista de ser óptima. Según los datos del Registro de la ERA-EDTA, referidos a 13.044 pacientes incidentes en HD, la utilización de un CVC para iniciar programa de HD ha aumentado significativamente desde el 58% en el año 2005 hasta el 68% en el año 2009. A partir de los datos procedentes del Registre de Malalts Renals de Catalunya sobre unos 10.000 pacientes incidentes en HD, se ha puesto de manifiesto que aproximadamente el 50% de los enfermos con enfermedad renal crónica (ERC) iniciaron el tratamiento de HD cada año en Catalunya a través de un CVC durante el período 2000-2011.

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