The primary aim of this chapter is to understand the importance of placement and maintenance of arteriovenous fistula (AVF) in the patients with advanced renal failure prior to the need for dialysis. Vascular access complications contribute significantly to the morbidity and mortality associated with end-stage renal disease patients on hemodialysis. The major concern this publication will addre...

Reference is made to a personal series of vascular accesses for haemodialysis on 273 patients aged 6 months to 70 yr. During the course of 12 years, 533 operations were performed: 109 cannulations of the saphena, 152 by-pass, 251 arteriovenous fistulae (including 22 on patients under 10 yr of age), and 21 "difficult accesses". An assessment of the advantages and disadvantages of the techniques ...

A successful functioning vascular access is the “lifeline” for a hemodialysis patient. Hemodialysis vascular access dysfunction is a major cause of morbidity and mortality in hemodialysis patients1-3. Improving vascular access outcomes remains an ongoing challenge for nephrologists, vascular access surgeons, and interventionists. In arteriovenous fistulas (AVF) and grafts (AVG), the most common...

The protective effects of statins against stenosis for permanent hemodialysis access have been repeatedly demonstrated in animal studies, but remain controversial in human studies. This study aims to evaluate the association between statin use and permanent hemodialysis access patency using a nationwide hemodialysis cohort. A total of 9862 pairs of statin users and non-users, matched by age and...

A new blood access system for hemodialysis (HD) addresses the major shortcomings of current accessing techniques and helps overcome patient adversity with available choices. The system uses new methods, devices and compositions comprising several novel elements: (1) totally implanted port, elementally simple in design, small and robust with improved safety features, (2) engineered transcutaneou...

Patients with acute kidney failure (AKF) and chronic kidney failure (CKF) require an appropriate vascular access for hemodialysis [1]. Vascular access is needed to allow blood flow through an extracorporeal circulation system with a blood pump connected to a hemodialysis monitor driving the blood through a dialysis filter (dialysator). Satisfactory levels of blood flow range between 300 and 400...

Dr. Steve J. Schwab (Vice-Chairman, Department of Medicine, Duke University Medical Center, and Professor of Medicine, Duke University School of Medicine, Durham, North Carolina, USA): This case exemplifies the current state of the art for the management of vascular access for hemodialysis. The predominant form of vascular access currently in the United States is the polytetrafluoroethylene (PT...

A progressive rise in the number of patients accepted for renal replacement therapy has been reported world wide [1]. Permanent vascular access (VA) is the life-line for the majority of these patients, when hemodialysis is the treatment of choice. Thus, the successful creation of permanent vascular access and the appropriate management to decrease the complications is mandatory. A well function...

Mild hyperhomocysteinemia, a putative risk factor for atherothrombotic cardiovascular disease morbidity and mortality, may contribute to the excess incidence of atherothrombotic outcomes in the dialysis-dependent end-stage renal disease population. Hemodialysis access (fistula or graft) thrombosis is an unfortunately common and costly morbidity in this patient population. In this study, using a...