RESUMO
Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access.
Assuntos
Derivação Arteriovenosa Cirúrgica/tendências , Pesquisa Biomédica/tendências , Implante de Prótese Vascular/tendências , Cateterismo Venoso Central/tendências , Publicações Periódicas como Assunto/tendências , Diálise Renal/tendências , Bibliometria , Humanos , Fatores de TempoRESUMO
We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access.
Assuntos
Educação Médica Continuada , Angioplastia/educação , Angioplastia/métodos , Fístula Arteriovenosa/cirurgia , Camboja , Feminino , Humanos , Masculino , Dispositivos de Acesso VascularRESUMO
This review addresses the development of dialysis services in Africa in the face of past and contemporary challenges. Maintenance dialysis treatment programs developed in 29 countries over the past 50 years, usually many years after their independence and the end of subsequent territorial and civil wars. Eight countries had the resources to launch national dialysis programs, conventionally defined as those accommodating at least 100 patients per million population. Additionally, based on information obtained from international and local publications, conference proceedings, and personal communications, it appears that limited short-term dialysis therapy currently is available in most African countries. Currently, the prevalence of and outcomes associated with dialysis in Africa are influenced significantly by the following: (1) local health indexes, including the prevalence of undernutrition and chronic infections; (2) per capita gross domestic product; (3) national expenditures on health and growth of these expenditures with incremental demand; (4) availability and adequate training of health care providers; and (5) literacy. In an attempt to reduce the socioeconomic burden of maintenance dialysis treatment, 12 countries have adopted active transplantation programs and 5 are striving to develop screening and prevention programs. Our recommendations based on these observations include optimizing dialysis treatment initiatives and integrating them with other health strategies, as well as training and motivating local health care providers. These steps should be taken in collaboration with regulatory authorities and the public.
Assuntos
Atenção à Saúde/tendências , Países em Desenvolvimento , Diálise Renal/tendências , Insuficiência Renal Crônica/etnologia , Insuficiência Renal Crônica/terapia , África/etnologia , Atenção à Saúde/economia , Países em Desenvolvimento/economia , Pessoal de Saúde/economia , Pessoal de Saúde/tendências , Humanos , Diálise Renal/economia , Insuficiência Renal Crônica/economiaRESUMO
RESUMEN El camino para llegar a la diálisis peritoneal (DP) como tratamiento de la enfermedad renal crónica (ERC) avanzada estuvo jalonado por hitos a lo largo de la historia. Los conocimientos sobre la anatomía del peritoneo fueron aportados por los embalsamadores egipcios, Galeno (siglo II), y Vesalio (siglo XVI). Recién en 1628 Asellius Gaselli describe los capilares linfáticos abdominales. El siglo XIX fue rico en avances: se identificarn la célula como unidad de los seres vivos y el fenómeno de ósmosis (Dutrochet, 1828), los cristaloides y coloides y su pasaje o no a través de una membrana (Graham T, 1850), el flujo de solutos y partículas a través de la membrana peritoneal (v.Recklinghausen, 1863), la absorción de sustancias hipotónicas y el aumento del efluente con las hipertónicas (Wegner G, 1877), y experimentos en animales confirmaron que la remoción de fluidos y otras sustancias ocurría primariamente a través de vasos sanguíneos (Starling & Tubby, 1894). Pero recién en el siglo 20 se utilizó la DP como tratamiento. El primer intento de utilizar el peritoneo para tratar la uremia lo realizó Georg Ganter en 1923, primero en animales con ligadura de uréteres y luego en dos pacientes. Recién en 1937 se publicó el primer caso que sobrevivió a un "lavaje "peritoneal (Wear y col), pero fueron Fine, Frank y Seligman quienes inicialmente en perros nefrectomizados y luego en pacientes con injuria renal aguda (IRA) demostraron que el método no sólo era viable, sino también efectivo. Luego continuaron los progresos, sobre todo para pacientes con IRA, pero también en algunos casos con ERC avanzada: el doble frasco colgante (Maxwell M, 1959), la diálisis crónica intrahospitalaria con cicladora (Tenckoff y col, 1965), las bolsas plásticas para DP, hasta que en 1975 Moncrief y col pusieron en marcha la DP continua ambulatoria, y en 1981 se introdujo la DP automatizada. Los años noventa fueron de expansión de la DP, hoy instalada como una de las alternativas de tratamiento de la ERC avanzada.
ABSTRACT Milestones throughout history marked the path to reach peritoneal dialysis (PD) as a treatment for advanced chronic kidney disease (CKD). The Egyptian embalmers, Galen (2nd century) and Vesalius (16th century) provided knowledge about the anatomy of the peritoneum. It was not until 1628 that Asellius Gaselli described the abdominal lymphatic capillaries. The 19th century was rich in advances: the cell was identified as the unit of living beings and the phenomenon of osmosis (Dutrochet, 1828), crystalloids and colloids and their passage or not through a membrane (Graham T, 1850), the flow of solutes and particles through the peritoneal membrane (Recklinghausen, 1863), the absorption of hypotonic substances and the increase in effluent with hypertonic ones (Wegner G, 1877), and animal experiments confirmed that fluid removal and other substances occurred primarily through blood vessels (Starling & Tubby, 1894). But it was not until the 20th century that PD was applied as treatment. The first attempt to use the peritoneum to treat uremia was made by Georg Ganter in 1923, first in animals with ureteral ligation and then in two patients. It was not until 1937 that the first case that survived a peritoneal "lavage" was published (Wear et al), but it was Fine, Frank and Seligman who initially in nephrectomized dogs and later in patients with acute kidney injury (ARI) demonstrated that the method was not only viable, but also succesful. Then progress continued, especially for patients with ARI, but also in some cases with advanced CKD: the double hanging bottle (Maxwell M, 1959), chronic intrahospital dialysis with a cycler (Tenckoff et al, 1965), plastic bags for PD, until 1975 when Moncrief et al launched continuous ambulatory PD, and in 1981 automated PD was introduced. The 1990s saw the expansion of PD, to date installed as one of treatment alternatives for advanced CKD.
RESUMO
RESUMEN El camino para llegar a la diálisis peritoneal (DP) como tratamiento de la enfermedad renal crónica (ERC) avanzada estuvo jalonado por hitos a lo largo de la historia. Los conocimientos sobre la anatomía del peritoneo fueron aportados por los embalsamadores egipcios, Galeno (siglo II), y Vesalio (siglo XVI). Recién en 1628 Asellius Gaselli describe los capilares linfáticos abdominales. El siglo XIX fue rico en avances: se identificarn la célula como unidad de los seres vivos y el fenómeno de ósmosis (Dutrochet, 1828), los cristaloides y coloides y su pasaje o no a través de una membrana (Graham T, 1850), el flujo de solutos y partículas a través de la membrana peritoneal (v.Recklinghausen, 1863), la absorción de sustancias hipotónicas y el aumento del efluente con las hipertónicas (Wegner G, 1877), y experimentos en animales confirmaron que la remoción de fluidos y otras sustancias ocurría primariamente a través de vasos sanguíneos (Starling & Tubby, 1894). Pero recién en el siglo 20 se utilizó la DP como tratamiento. El primer intento de utilizar el peritoneo para tratar la uremia lo realizó Georg Ganter en 1923, primero en animales con ligadura de uréteres y luego en dos pacientes. Recién en 1937 se publicó el primer caso que sobrevivió a un "lavaje "peritoneal (Wear y col), pero fueron Fine, Frank y Seligman quienes inicialmente en perros nefrectomizados y luego en pacientes con injuria renal aguda (IRA) demostraron que el método no sólo era viable, sino también efectivo. Luego continuaron los progresos, sobre todo para pacientes con IRA, pero también en algunos casos con ERC avanzada: el doble frasco colgante (Maxwell M, 1959), la diálisis crónica intrahospitalaria con cicladora (Tenckoff y col, 1965), las bolsas plásticas para DP, hasta que en 1975 Moncrief y col pusieron en marcha la DP continua ambulatoria, y en 1981 se introdujo la DP automatizada. Los años noventa fueron de expansión de la DP, hoy instalada como una de las alternativas de tratamiento de la ERC avanzada.
ABSTRACT Milestones throughout history marked the path to reach peritoneal dialysis (PD) as a treatment for advanced chronic kidney disease (CKD). The Egyptian embalmers, Galen (2nd century) and Vesalius (16th century) provided knowledge about the anatomy of the peritoneum. It was not until 1628 that Asellius Gaselli described the abdominal lymphatic capillaries. The 19th century was rich in advances: the cell was identified as the unit of living beings and the phenomenon of osmosis (Dutrochet, 1828), crystalloids and colloids and their passage or not through a membrane (Graham T, 1850), the flow of solutes and particles through the peritoneal membrane (Recklinghausen, 1863), the absorption of hypotonic substances and the increase in effluent with hypertonic ones (Wegner G, 1877), and animal experiments confirmed that fluid removal and other substances occurred primarily through blood vessels (Starling & Tubby, 1894). But it was not until the 20th century that PD was applied as treatment. The first attempt to use the peritoneum to treat uremia was made by Georg Ganter in 1923, first in animals with ureteral ligation and then in two patients. It was not until 1937 that the first case that survived a peritoneal "lavage" was published (Wear et al), but it was Fine, Frank and Seligman who initially in nephrectomized dogs and later in patients with acute kidney injury (ARI) demonstrated that the method was not only viable, but also succesful. Then progress continued, especially for patients with ARI, but also in some cases with advanced CKD: the double hanging bottle (Maxwell M, 1959), chronic intrahospital dialysis with a cycler (Tenckoff et al, 1965), plastic bags for PD, until 1975 when Moncrief et al launched continuous ambulatory PD, and in 1981 automated PD was introduced. The 1990s saw the expansion of PD, to date installed as one of treatment alternatives for advanced CKD.