No abstract

There are currently more than 2 million end-stage kidney disease (ESKD) patients who require kidney replacement therapy worldwide, 1 and this is estimated to rise to over 5 million by 2030. 2 While a kidney transplant is the ideal therapy, hemodialysis (HD) is used by the majority (60-70%) of ESKD patients. 3 HD requiresvascular access via a central vascular catheter, an arteriovenous fistula, or a synthetic graft. Hemodialysis with a fistula or graft requires the insertion of two needles to access the blood flow; venous needle dislodgement can happen when the venous needle becomes dislocated out of the vascular access, resulting in blood loss. At typical hemodialysis blood flow rates of 400-500 mL/minute, it can take only minutes for the patient to lose over 40% of his or her blood volume (the point at which hemorrhagic shock occurs). 4 VND represents a potentially life-threatening situation and a real cost to the patient and the health service, with interventions required including ICU or emergency department admissions, increased erythropoietin use, pathology testing and blood transfusions. 5