Erstellung des Gefäßzugangs zur chronischen Hämodialyse – Was ist Aufgabe des Nephrologen?

The nephrologist has central duties in the creation of the vascular access. Vascular protection requires the selection of the most suitable shunt arm. This can only be taken into consideration if determined early when placing central venous catheters, pacemakers or by coronary angiography via the radial artery. If the choice of dialysis method is hemodialysis, the nephrologist, with interdisciplinary support from vascular surgeons, cardiologists and others, will counsel the patient and recommend a native shunt, a prosthetic shunt or an atrial catheter. Under good conditions the creation of the arteriovenous fistula with an estimated glomerular filtration rate of 15 ml/min is recommended. After shunt placement, the nephrologist is the physician with the closest patient contact. Supported by sonography and flow measurements, the maturation of the fistula can be monitored. The goal is for the patient to begin chronic hemodialysis treatment with a vascular access that is individually the best suited.