Vascular Access Guidelines Being Developed in Japan
Mr. Hidetoshi Saio of Nipro Corporation reports
that the Japanese government is now developing a customized version of the US K/DOQI guidelines for vascular access. A key physician in Japan is writing the
guidelines that will be announced at a Japanese nephrology society meeting in October.
Since there is a high fistula population in
Japan, the guideline may well mimic the Canadian guidelines which state, “Monitor AV fistula bimonthly for hemodynamically significant stenoses, using an on-line total access flow measurement. Investigate an access flow less than 500 ml/min or a drop in access flow >20% of baseline for possible reversible lesions.” The Canadian guidelines also state that the preferred method of monitoring vascular accesses is intra-access flow. These accesses can be measured by indicator dilution or conductivity tracer techniques, using the Krivitski method.
