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UK organisation of access care.

Wilmink, Teun and Powers, Sarah and Baharani, Jyoti (2015) UK organisation of access care. The journal of vascular access, 16 Sup. pp. 5-10. ISSN 1724-6032. This article is accessible to all HEFT staff and students via NICE Evidence www.evidence.nhs.uk by using their HEFT Athens login ID's.

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Official URL: http://www.vascular-access.info/article/uk-organis...

Abstract

National UK audits show that 73% of patients start renal replacement therapy (RRT) with haemodialysis (HD). However, 59% of those start HD on non-permanent access in the form of a tunnelled line (TL) or a non-tunnelled line (NTL), 40% on an arteriovenous fistula (AVF) and 1% on an arteriovenous graft (AVG). After 3 months, the number of patients dialysing on AVF was only 41%. Late referrals, within 90 days of starting dialysis to the renal service, occur in one-fifth of all incident HD patients. Referral to a surgeon was an important determinant of mode of access at first dialysis. However, referral to a surgeon occurred in 67% of patients who were known to the nephrologist for over a year and in 46% of patients who were known to nephrology less than a year but more than 90 days. Best practice tariffs of the National Health Service (NHS) payment by results program have set a target of 75% of prevalent HD occurring via an AVF or AVG in 2011/2012, rising to 85% in 2013/2014. We suggest that this target is best achieved by increasing timely referral to a surgeon for creation of access before HD is needed.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NICE Evidence www.evidence.nhs.uk by using their HEFT Athens login ID's.
Subjects: WJ Urogenital system. Urology
Divisions: Emergency Services > Renal
Planned IP Care > General Surgery
Related URLs:
Depositing User: Miss Adele Stanton
Date Deposited: 30 May 2015 06:36
Last Modified: 30 May 2015 06:36
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/819

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