Importance Of Fistula First Approach To Dialysis Access

In recent times, importance of fistulafirstapproach to dialysis access has become increasingly relevant in various contexts. FistulaFirst Initiative: Historical Impact on Vascular Access Practice .... In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. WHAT IS FISTULA FIRST - Centers for Medicare & Medicaid Services. Equally important, aVFs are considered the best vascular access because they demonstrate the best overall performance, have fewer infections which can lead to hospitalizations, tend to last for a longer time than other access types and allow for increased blood flow resulting in a more adequate dialysis treatment.

Fistula First: Recent Progress and Ongoing Challenges. With frequent feedback from the dialysis networks, nephrologists rapidly succeeded in providing the vast majority of their hemodialysis patients with an adequate Kt/V and hemoglobin. In contrast, increasing arteriovenous fistula (AVF) use in hemodialysis patients proved to be much more challenging. NKF and The Fistula First Breakthrough Initiative.

According to the National Kidney Foundation, arteriovenous (AV) fistula, which connects a vein to a nearby artery in the arm, is the preferred access out of the three methods available for hemodialysis patients. AV fistula lasts longer and has a lower rate of infections and other complications. A Requiem for Fistula First. It's important to note that, first, patients with an initial AV fistula required more vascular access procedures annually, as compared with those with an initial AV graft. Second, the median annual cost of access management per patient was almost $4000 greater in those receiving an AV fistula versus a graft.

Embracing the fistula first national vascular access improvement .... Similarly, in the United States, the number of end-stage renal disease (ESRD) patients on hemodialysis (HD) exceeds 300,000 and increases exponentially each year. Creating a functional and durable vascular access for these patients must be a priority.

The gold standard for HD access is unambiguously the autogenous arteriovenous fistula (AVF). In this context, the Survival Benefit of “Fistula First, Catheter Last” in Hemodialysis .... Patients needing hemodialysis are advised to have arteriovenous fistulas rather than catheters because of significantly lower mortality rates.

However, disparities in fistula placement raise the possibility that patient factors have a role in this apparent mortality benefit. Fistula First or Catheter Last? While each type of access has risks and benefits evidence has shown that a high quality AVF is the optimal access in dialysis patients. In order to standardize access creation many guidelines have been developed focusing on a “fistula first” mentality.

Fistula First clarifies its message - ScienceDirect. The coalition seeks an autogenous access rate of 66% in prevalent HD patients. Fistula First clarifies its message - Journal of Vascular Surgery.