Semin intervent Radiol 2004; 21(2): 119-124
DOI: 10.1055/s-2004-833685
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

K/DOQI Guidelines: What Should an Interventionalist Know?

Aalpen A. Patel1 , 3 , Catherine M. Tuite1 , 3 , Scott O. Trerotola2 , 3
  • 1Assistant Professor of Radiology and Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  • 2Professor of Radiology and Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  • 3Department of Radiology, Interventional Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
13 September 2004 (online)

The Kidney Disease Outcomes Quality Initiative (K/DOQI) is an evolving, literature-based set of practice guidelines designed to improve measurably the quality of life for dialysis patients. As is characteristic of guidelines, they do not change as rapidly as the literature. The K/DOQI guidelines are not meant as the definitive document and should be not treated as such. Although the guidelines are not perfect, everyone caring for chronic renal patients should be very familiar with the guidelines. It is perfectly acceptable to adopt approaches that differ from the guidelines as long as they are supported by literature. An attempt is made in this article to review the aspects of the guidelines most pertinent to the interventionalist and outline deviations from the guidelines that are supported by literature.

REFERENCES

  • 1 , NKF-K/DOQI Clinical Practice Guidelines: Update 2000, Executive Summary. Available at www.kidney.org/professionals/kdoqi/guidelines_updates/doqi_upex.html Accessed January 7, 2004; 
  • 2 , NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: Update 2000, Executive Summary, Introduction. Available at www.kidney.org/professionals/kdoqi/guidelines_updates/doqiupva_intro.html Accessed January 7, 2004; 
  • 3 Churchill D N, Taylor D W, Cook R J et al.. Canadian hemodialysis morbidity study.  Am J Kidney Dis. 1992;  19 214-234
  • 4 Mehta S. Statistical summary of clinical results of vascular access procedures for haemodialysis. In: Sommer BG, Henry ML Vascular Access for Hemodialysis-II. W.L. Gore & Associates 1991: 145-157
  • 5 Feldman H I, Kobrin S, Wasserman A. Hemodialysis vascular access morbidity.  J Am Soc Nephrol. 1996;  7 523-535
  • 6 Feldman H I, Held P J, Hutchinson J T, Stoiber E, Hartigan M F, Berlin J A. Hemodialysis vascular access morbidity in the United States.  Kidney Int. 1993;  43 1091-1096
  • 7 Besarab A, Sullivan K L, Ross R P, Moritz M J. Utility of intra-access pressure monitoring in detecting and correcting venous outlet stenoses prior to thrombosis.  Kidney Int. 1995;  47 1364-1373
  • 8 Trerotola S O. DOQI Guidelines Update.  J Vasc Interv Radiol. 2003;  14 354S
  • 9 , NKF-K/DOQI History. Available at www.kidney.org/professionals/kdoqi/history.cfm Accessed January 7, 2004; 
  • 10 NKF-DOQI clinical practice guidelines for vascular access . National Kidney Foundation-Dialysis Outcomes Quality Initiative.  Am J Kidney Dis. 1997;  30(4 suppl 3) S150-S191
  • 11 Trerotola S O. The Dialysis Outcomes Quality Initiative: get your copy now!.  J Vasc Interv Radiol. 2003;  14 S353-S354
  • 12 , NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: Update 2000. Available at: www.kidney.org/professionals/kdoqi/guidelines_updates/doqi_uptoc.html#va Accessed January 7, 2004; 
  • 13 The CARI Guidelines: Caring for Australians with Renal Impairment.  , Available at: www.kidney.org.au/cari/drafts/bvascular.html Accessed January 7, 2004; 
  • 14 Collins A J, Roberts T L, St Peter W L, Chen S C, Ebben J, Constantini E. United States Renal Data System assessment of the impact of the National Kidney Foundation-Dialysis Outcomes Quality Initiative guidelines.  Am J Kidney Dis. 2002;  39 784-795
  • 15 Trerotola S O. Interventional radiology in central venous stenosis and occlusion.  Semin Interv Radiol. 1994;  11 291-304
  • 16 Schwab S J, Quarles L D, Middleton J P, Cohan R H, Saeed M, Dennis V W. Hemodialysis-associated subclavian vein stenosis.  Kidney Int. 1988;  33 1156-1159
  • 17 Surratt R S, Picus D, Hicks M E, Darcy M D, Kleinhoffer M, Jendrisak M. The importance of preoperative evaluation of the subclavian vein in dialysis access planning.  AJR Am J Roentgenol. 1991;  156 623-625
  • 18 Korzets A, Chagnac A, Ori Y, Katz M, Zevin D. Subclavian vein stenosis, permanent cardiac pacemakers and the haemodialysed patient.  Nephron. 1991;  58 103-105
  • 19 Da Costa S S, Scalabrini Neto A, Costa R, Caldas J G, Martinelli Filho M. Incidence and risk factors of upper extremity deep vein lesions after permanent transvenous pacemaker implant: a 6-month follow-up prospective study.  Pacing Clin Electrophysiol. 2002;  25 1301-1306
  • 20 Lameris J S, Post P JM, Zonderland H M, Gerritsen P G, Kappers-Klunne M C, Schutte H E. Percutaneous placement of Hickman catheters: comparison of sonographically guided and blind techniques.  AJR Am J Roentgenol. 1990;  155 1097-1099
  • 21 Mallory D L, McGee W T, Shawker T H et al.. Ultrasound guidance improves the success rate of internal jugular vein cannulation.  Chest. 1990;  98 157-160
  • 22 Lund G B, Trerotola S O, Scheel Jr P J. Percutaneous translumbar inferior vena cava cannulation for hemodialysis.  Am J Kidney Dis. 1995;  25 732-737
  • 23 Zaleski G X, Funaki B, Lorenz J M et al.. Experience with tunneled femoral hemodialysis catheters.  AJR Am J Roentgenol. 1999;  172 493-496
  • 24 Elduayen B, Martinez-Cuesta A, Vivas I, Delgado C, Pueyo J C, Bilbao J I. Central venous catheter placement in the inferior vena cava via the direct translumbar approach.  Eur Radiol. 2000;  10 450-454
  • 25 Trerotola S O, Johnson M S, Shah H et al.. Tunneled hemodialysis catheters: use of a silver-coated catheter for prevention of infection-a randomized study.  Radiology. 1998;  207 491-496
  • 26 Sasadeusz K J, Trerotola S O, Shah H et al.. Tunneled jugular small-bore central catheters as an alternative to peripherally inserted central catheters for intermediate-term venous access in patients with hemodialysis and chronic renal insufficiency.  Radiology. 1999;  213 303-306
  • 27 Trerotola S O, Kraus M, Shah H et al.. Randomized comparison of split tip versus step tip high-flow hemodialysis catheters.  Kidney Int. 2002;  62 282-289
  • 28 Hilleman D E, Dunlay R W, Packard K A. Reteplase for dysfunctional hemodialysis catheter clearance.  Pharmacotherapy. 2003;  23 137-141
  • 29 Savader S J, Ehrman K O, Porter D J, Haikal L C, Oteham A C. Treatment of hemodialysis catheter-associated fibrin sheaths by rt-PA infusion: critical analysis of 124 procedures.  J Vasc Interv Radiol. 2001;  12 711-715
  • 30 Savader S J, Haikal L C, Ehrman K O, Porter D J, Oteham A C. Hemodialysis catheter-associated fibrin sheaths: treatment with a low-dose rt-PA infusion.  J Vasc Interv Radiol. 2000;  11 1131-1136
  • 31 Gray R J, Levitin A, Buck D et al.. Percutaneous fibrin sheath stripping versus transcatheter urokinase infusion for malfunctioning well positioned tunneled central venous dialysis catheters: a prospective, randomized trial.  J Vasc Interv Radiol. 2000;  11 1121-1129
  • 32 Beathard G A. Management of bacteremia associated with tunneled-cuffed hemodialysis catheters.  J Am Soc Nephrol. 1999;  10 1045-1049
  • 33 Tanriover B, Carlton D, Saddekni S et al.. Bacteremia associated with tunneled dialysis catheters: comparison of two treatment strategies.  Kidney Int. 2000;  57 2151-2155
  • 34 Moist L M, Churchill D N, House A A et al.. Regular monitoring of access flow compared with monitoring of venous pressure fails to improve graft survival.  J Am Soc Nephrol. 2003;  14 2645-2653
  • 35 Turmel-Rodrigues L. Application of percutaneous mechanical thrombectomy in autogenous fistulae.  Tech Vasc Interv Radiol. 2003;  6 42-48
  • 36 Hagge P, Vorwerk D, Wildberger J E et al.. Percutaneous treatment of thrombosed primary arteriovenous hemodialysis access fistulae.  Kidney Int. 2000;  57 1169-1175

Aalpen A PatelM.D. 

Assistant Professor of Radiology, University of Pennsylvania School of Medicine, Department of Radiology, Interventional Radiology

One Silverstein, 3400 Spruce Street

Philadelphia, PA 19104

Email: aalpen.patel@uphs.upenn.edu