Effect of Early Cannulation with Plastic Cannula on Arteriovenous Fistula Patency in Hemodialysis Patients

Abstract

Introduction: Plastic cannulas have been used to cannulate arteriovenous fistulas (AVFs) for hemodialysis (HD) in Japan for many years. However, the effect of early cannulation with plastic cannulas on AVF patency is not known. Objective: We analyzed the relationship between first cannulation time (FCT) and patency rates for AVFs cannulated with plastic cannulas and investigated whether early cannulation with plastic cannulas affects AVF patency. Methods: In total, 122 patients who underwent primary AVF construction were divided into an early cannulation group (FCT <10 days) and a late cannulation group (FCT ≥10 days). The Kaplan-Meier method and multivariable Cox regression models were used to investigate AVF patency. Results: Median FCT was 6 days. There was no statistically significant between-group difference in primary (p = 0.643) or secondary (p = 0.453) patency rates. Early or late cannulation was not significantly associated with primary patency (hazard ratio [HR] 1.21; 95% CI 0.71–2.05) or secondary patency (HR 0.46; 95% CI 0.08–2.77) after adjustment for age, sex, presence of diabetes mellitus or hypertension, and HD at baseline. Conclusions: Early AVF cannulation (<10 days from creation) with plastic cannulas does not affect access patency, and it may be possible to cannulate AVFs earlier than 10 days to decrease the need for use of a central venous catheter.

Efficacy and Safety of Plastic Cannulae Compared with Metal Needles in the Initial Use of an Arteriovenous Fistulae in Incident Hemodialysis Patients: A Randomized Controlled Study

“…This may contribute to the remarkable superiority of Japanese vascular access-related outcomes compared to other countries. Moreover, the AVF implementation rate in Japan is considerably higher than in other countries associated with the use of plastic cannulae, and the time to first needling is only 2-4 weeks, shorter than the period of 4-6 weeks in other countries [24]. Based on Japanese experience, plastic cannulae have also been used in renal units in Australia since 2013 with excellent results [13].…”

Plastic cannulae versus metal needle cannulation in haemodialysis: Results of an international survey from the nurse perspective

“…In a randomised controlled pilot study, 16 the patient group who received metal needles had statistically significant differences in complications such as mechanical trauma and infiltrations during HD. Shi et al 17 reports that extravasation phenomena and risk of haematoma or aborted dialysis session are lower in the plastic cannula group than in metal needle group. The cost of the interventions related to the treatment of complications led to a large increase in expenditure for the group who received metal needles.…”

Expert consensus on the establishment and maintenance of native arteriovenous fistula

“…Researchers believe that early AVF puncture (<10 days after creation) using an plastic cannula does not affect the patency rate, and it is possible to perform AVF puncture before 10 days to reduce the use of CVC. 106 …”

“…Researchers believe that early AVF puncture (<10 days after creation) using an plastic cannula does not affect the patency rate, and it is possible to perform AVF puncture before 10 days to reduce the use of CVC. 106 A single-center, prospective, randomized clinical trial in South Korea studied 16 HD patients, and all patients had AVG vascular access. They randomly divided eight cases in the metal needle group and eight cases in the plastic cannula group.…”