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Dialyse 2016

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Dialyseshunts

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Zusammenfassung

Der Dialysezugang stellt einen entscheidenden Faktor für das Überleben des Dialysepatienten dar. Dem Nephrologen kommt hierbei eine zentrale Bedeutung zu. In Abhängigkeit von der Nierenfunktionsentwicklung und der anstehenden Notwendigkeit der Dialyseeinleitung ist eine zeitige Planung des Dialysezuganges notwendig. Bei Entscheidung zur Hämodialyse sind die zeitgerechte primäre Anlage einer (nativen) arteriovenösen Fistel und die Vermeidung eines zentralvenösen Zuganges unbedingt anzustreben. Bei Vorstellung des Patienten in bereits fortgeschrittenem Stadium der Niereninsuffizienz sind die Risiken des zentralvenösen Katheters als Dialysezugang gegenüber den Möglichkeiten einer sofortigen Shuntanlage mit einem zeitlich verzögerten Beginn der Hämodialyse oder einer vorübergehenden Peritonealdialyse mit akutem Start abzuwägen. Die Sicherstellung eines suffizienten Dialyseshunts stellt weiterhin eine anhaltende interdisziplinäre Herausforderung dar.

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Authors and Affiliations

  1. Nephrologisches Zentrum Mettmann, Gartenstr. 8, 40822, Mettmann, Deutschland

    S. Aker

  2. Nephrologisches Zentrum Mettmann, Gartenstr. 8, 40822, Mettmann, Deutschland

    M. Koch

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  1. S. Aker
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Correspondence to S. Aker .

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  1. Solingen, Germany

    Wolfgang Hepp

  2. Nephrologisches Zentrum Mettmann , Mettmann, Nordrhein-Westfalen, Germany

    Michael Koch

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Aker, S., Koch, M. (2017). Dialyse 2016. In: Hepp, W., Koch, M. (eds) Dialyseshunts. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52699-6_2

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