Clinical Practice Guidelines and Clinical Practice Recommendations
2006 Updates
Hemodialysis Adequacy
Peritoneal Dialysis Adequacy
Vascular Access



Table 1
Patient Evaluation Prior to Access Placement
Table 2 Skin Preparation Technique for Subcutaneous AV Accesses
Table 3 Technique for Mature AVF Cannulation
Table 4 Technique for AVG Cannulation
Table 5 Access Physical Examination
Table 6 Considerations for Accessing Catheters and Cleansing Catheter Exit Sites
Table 7 Flow Methods in Dialysis Access
Table 8 Static Intra-Access Pressure (IAP) Surveillance
Table 9 Criteria for Intervention
Table 10 Access Flow Protocol Surveillance
Table 11 Diagnostic Accuracy of Tests Used for Access Surveillance in the HD Population: Angiogram for Stenosis versus Other Test
Table 12 Comparison of Diagnostic Tests for Access Surveillance and Monitoring in the HD Population: Duplex Doppler Ultrasound as Reference
Table 13 Comparison of Diagnostic Tests to Predict Thrombosis in Chronic HD Patients
Table 14 Comparison of Newer Tests to Established Tests for Stenosis Detection
Table 15 Patient Education Basics
Table 16 Access Surveillance Studies With PTA Intervention
Table 17 Summary of Physical Examination
Table 18 Signs of CVC Dysfunction: Assessment Phase
Table 19 Prophylaxis of TCC-Related Thrombosis
Table 20 Causes of Early Catheter Dysfunction
Table 21 Available Thrombolytics
Table 22 Effect of Lytics in Occluded Hemodialysis Catheters
Table 23 Treatments of TCC Fibrin Sheath Occlusion
Table 24 Prophylaxis for Dual-Lumen TCC-Related Infections
Table 25 Semipermanent HD Catheter and Patient Size Guideline


Figure 1. Starting a Buttonhole
Figure 2. Cannulating a Buttonhole
Figure 3. Pressure Profiles in Grafts (top) and Fistulae (bottom)
Figure 4. IAPs Within Normal Grafts and Fistulae
Figure 5. Effect of Venous Outlet Stenosis on Pressure Profile
Figure 6. Effect of Graft Venous Outlet Stenosis
Figure 7. Relationship of IAP Ratio to Access Flow
Figure 8. Treatment of Stenosis
Figure 9. Assessing Dysfunction of Catheters
Figure 10. Fibrin Sheath (A) Prior to Therapy and (B) After Treatment With PTA
Figure 11. Pediatric Progress From CKD Stages 1 to 5 and KRT/Access Algorithm