he establishment and maintenance of a functioning vascular access that serves as a patient’s lifeline while on therapy. While the selection of a vascular access type is influenced by individual patient circumstances, the arteriovenous fistula is generally the preferred access method. Training patients to utilize their dialysis access requires attention to safety, risk management, and monitoring for complications to minimize adverse events and technique failure. Policies incorporating systematic frameworks for quality improvement and assurance, in conjunction with the measurement of metrics relating to vascular access, are tools that should be employed by HHD programs to enhance the value of care delivered. In this Perspective, we aim to describe what is currently known about the various vascular access options in HHD and to elucidate what needs to be taken into consideration in the selection and care of this access. There is a global interest in expanding home dialysis utilization amongst patients with end-stage kidney disease. Home hemodialysis (HHD) is an appealing kidney replacement therapy option for this population due to its multiple clinical and quality of life benefits. Central to successful HHD is the establishment and maintenance of a functioning vascular access that serves as a patient’s lifeline while on therapy. While the selection of a vascular access type is influenced by individual patient circumstances, the arteriovenous fistula is generally the preferred access method. Training patients to utilize their dialysis access requires attention to safety, risk management, and monitoring for complications to minimize adverse events and technique failure. Policies incorporating systematic frameworks for quality improvement and assurance, in conjunction with the measurement of metrics relating to vascular access, are tools that should be employed by HHD programs to enhance the value of care delivered. In this Perspective, we aim to describe what is currently known about the various vascular access options in HHD and to elucidate what needs to be taken into consideration in the selection and care of this access. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

---

家庭血液透析中的血管通路注意事项


建立和维护功能正常的血管通路，作为患者治疗期间的生命线。虽然血管通路类型的选择受到患者个体情况的影响，但动静脉瘘通常是首选的通路方法。培训患者使用透析通道需要注意安全、风险管理和并发症监测，以尽量减少不良事件和技术失败。 HHD 计划应采用纳入质量改进和保证系统框架的政策，以及与血管通路相关的指标测量，以提高所提供护理的价值。在本篇文章中，我们的目的是描述目前已知的 HHD 中各种血管通路选项，并阐明在选择和护理该通路时需要考虑的因素。全球都对扩大终末期肾病患者的家庭透析利用率感兴趣。家庭血液透析 (HHD) 因其多种临床和生活质量益处而成为该人群颇具吸引力的肾脏替代治疗选择。成功 HHD 的核心是建立和维持功能正常的血管通路，作为患者治疗期间的生命线。虽然血管通路类型的选择受到患者个体情况的影响，但动静脉瘘通常是首选的通路方法。培训患者使用透析通道需要注意安全、风险管理和并发症监测，以尽量减少不良事件和技术失败。 HHD 计划应采用纳入质量改进和保证系统框架的政策，以及与血管通路相关的指标测量，以提高所提供护理的价值。在本篇文章中，我们的目的是描述目前已知的 HHD 中各种血管通路选项，并阐明在选择和护理该通路时需要考虑的因素。版权所有 © 2024 美国肾脏病学会...