Hemodiyaliz Damar Erişim Yolları ve Bakımı

Hemodiyaliz böbrek yetmezliğinin tedavisinde en yaygın kullanılan tek yöntem olmaya devam etmektedir. Hemodiyalizdeki yaşam süresi ve kalitesi, diyalizin kalitesiyle doğru orantılıdır ve bu kalite de hastanın damar erişim yolunun güvenilirliğine ve bütünlüğüne bağlıdır. En ideal damar erişim yolu, diyalizi uygulamak için güvenilir, komplikasyonsuz erişim sağlayan ve aynı zamanda hastanın ihtiyaçlarına uygun olandır. Son altmış yıldır hemodiyaliz vasküler erişim seçenekleri büyük ölçüde değişmemiştir ve arteriovenöz fistül (AVF) tercih edilen erişim olmaya devam etmektedir. AVF, hemodiyaliz için klinik uygulama kılavuzlarında önerilen ve tercih edilen vasküler bir girişim olmasına rağmen tromboz, hematom, ödem, periferik iskemi, kanama ve enfeksiyon gibi ciddi komplikasyonlarda gelişebilmektedir. Bu komplikasyonların önüne geçilmesinde hastalara AVF bakımına ilişkin eğitim verilmesi son derece önemlidir. Bu derleme hemodiyaliz hastalarına bakım veren sağlık çalışanlarına rehber olması için hazırlanmıştır.

Anahtar Kelimeler:

Damar yolu, hemodiyaliz, arteriovenöz greft, santral venöz kateter, arteriovenöz fistül, bakım, eğitim

Hemodialysis Vascular Access and Care

Hemodialysis remains the most widely used method for treating renal failure. Life expectancy and quality in hemodialysis are directly proportional to the quality of dialysis, and this quality depends on the reliability and integrity of the patient’s vascular access route. The ideal vascular access route provides reliable, uncomplicated access to dialysis and is also suitable for the patient’s needs. Hemodialysis vascular access options have not changed substantially over the past six decades, and arteriovenous fistula (AVF) remains the access of choice. Although AVF is a vascular intervention recommended and preferred in clinical practice guidelines for hemodialysis, it can develop into serious complications such as thrombosis, hematoma, edema, peripheral ischemia, bleeding, and infection. To prevent these complications, it is extremely important to educate patients about AVF care. This review has been prepared as a guide for healthcare professionals who care for hemodialysis patients.

Keywords:

Vascular access, hemodialysis, arteriovenous graft, central venous catheter, arteriovenous fistula, care, education,

PDF

___

Süleymanlar G. Hemodialysis principles and applications. Ankara: Sun Medical Bookstore, 2020; 1-29.
Yeniçerioğlu Y, Güngör Ö, Arıcı M. Basic nephrology. Ankara: Sun Medical Bookstore, 2019; 338-390.
Arık N, Ateş K, Süleymanlar G, Tonbul Z, Tüerk S, Yıldız A. Hemodialysis for Physicians. Ankara: Sun Medical Bookstore, 2009; 31-135.
Ateş K, Seyahi N, Koçyiğit İ. TC Joint Report of Ministry of Health and Turkish Society of Nephrology. 2021[cited 2022 march 15]. Available form: https://nefroloji.org.tr/tr/icerik/genel-5/turk-nefroloji-dernegi-registry-raporlari-508
Sezen A. Dialysis nursing. İstanbul: Nobel medical bookstore, 2014; 153-207.
Thomas N. Nursing care in kidney diseases. Translate: Karadakovan A. İstanbul: Nobel Academy, 2016; 165-206.
Karadakovan A, Eti Arslan F. Care in Internal and Surgical Diseases. 6th Edition. İstanbul: Academician Bookstore, 2022; 699-723.
Akdemir N. Internal Medicine and Nursing Care. 7th Edition. Ankara: Academician Bookstore, 2021; 723-786.
Çetin Ş, Çiğdem Z, Özsoy H. Vascular Access Routes and Nursing Care in Hemodialysis Patients. Turkey Clinics Journal of Nursing Sciences, 2018;10(2):144-152. https://doi.org/10.5336/nurses.2017-57483
Olgun N, Çelik S. Internal medicine nursing in all its aspects. Ankara: Nobel medical bookstore, 2021; 251-295.
Woo K, Fuld R, Grandinetti A, et al. Patient-reported outcomes in hemodialysis vascular access: A call to action. The Journal of Vascular Access, 2022; 23(6): 973-980. https://doi.org/10.1177/11297298211018295
Alkın Demir C, Özer Z. The Relationship of symptoms and comfort in patients receiving hemodialysis. Journal of Nephrology Nursing. 2022;17(1):10-20. https://doi.org/10.47565/ndthdt.2022.49
Yıldırım Keskin A, Özpulat F. Difficulties experienced by patients who receive hemodialysis treatment Due to Chronic Renal Failure. Health and Society. 2019;29(1): 32-43.
Şanlıtürk D, Ovayolu N, Kes D. Common problems in hemodialysis patients and the problem-solving recommendations. Turkish Society of Nephrology, Dialysis and Transplantation Nurses Journal of Nephrology Nursing. 2018;1(13):17-25.
Askeroğlu A, Demet A, Tercan F et al. Investigation of Self-Care Knowledge and Behaviors of Hemodialysis Patients Regarding Arteriovenous Fistula. Journal of Izmir Katip Celebi University Faculty of Health Sciences. 2021;6(3):133-138.
Güven ŞD, Turaç N. Fistula Care Knowledge Levels of Hemodialysis Patients. Bozok Medical Journal 2015;5:7-11.
Kavurmacı M. Determining the knowledge level of hemodialysis patients about fistula care. Çukurova University Journal of Health Sciences. 2016;31(1):39-47.
Ozen N, Tosun N, Cinar FI et al. Investigation of the knowledge and attitudes of patients who are undergoing hemodialysis treatment regarding their arteriovenous fistula. The Journal of Vascular Access, 2017;18:64-68. https://doi.org/10.5301/jva.5000618
Sousa CN, Marujo P, Teles P et al. Self‐care on hemodialysis: Behaviors with the arteriovenous fistula. Therapeutic Apheresis and Dialysis, 2017;21:195-199. https://doi.org/10.1111/1744-9987.12522
Mohammad Alizade F, Ghaffari M, Khodakarim S et al. The Investigation of the Effect of Educational Interventions Based on Health Belief Model for Promoting Fistula Care Behaviors of Hemodialysis Patients. GMJ Medicine, 2020;4:202-210.
Sousa CN, Paquete ARC, Teles P et al. Investigating the effect of a structured intervention on the development of self-care behaviors with arteriovenous fistula in hemodialysis patients. Clinical Nursing Research. 2021;30:866-874. https://doi.org/10.1177/1054773820974834
Köse E, Vural Doğru B, Gün M. The Effects of Arteriovenous Fistula Knowledge and Self-Care Behaviors of Hemodialysis Patients on Arteriovenous Fistula Complications. Arch Health Sci Res. 2021;8(2):110-116. https://doi.org/10.5152/archealthscires.2021.20100
Asar E, Bora F. Evaluation of Arteriovenous Fistula Training of Follow-Up Patients in Nephrology Low Clirens Out patient Clinic who Do Not Undergo Hemodialysis with Proper Working Arteriovenous Fistula: A Pilot Study. Journal of Nephrology Nursing. 2021;16(1):10-18. https://doi.org/10.47565/ndthdt.2021.28
Özdemir ST, Akyol AD. Training of Hemodialysis Patients with Arteriovenous Fistulas Affect Self-Care Behaviors of Patients? J Nephrol Nurs. 2019;14(2):45-56. https://doi.org/10.18185/erzifbed.1086627
Yang MM, Zhao HH, Ding XQ et al. Self-Care Behavior of Hemodialysis Patients with Arteriovenous Fistula in China: A Multicenter, Sectional Study. Ther Apher Dial. 2019;23(2):167-172. https://doi.org/10.1111/1744-9987.12770