Impact of arteriovenous fistula cannulation on the quality of dialysis

Abstract

Introduction: Adequate hemodialysis directly improves health. Puncturing an arteriovenous fistula (AVF) and the amount of blood recirculation greatly affect the quality of dialysis. Few studies have assessed the method to cannulate a fistula and its influence on efficiency of hemodialysis.Methods: This prospective pilot study included 14 patients with end-stage renal failure receiving regular intermittent hemodialysis. Patients received three consecutive treatments with both needles directed upstream then three consecutive treatments with the venous needle directed upstream and the arterial needle directed downstream. With both techniques, the distance between the needles was kept constant at 2.5 cm. Recirculation rate and Kt/V ratio were measured during each treatment using thermodilution and a diascan Fresenius generator.Findings: The 14 patients received 84 hemodialysis sessions: i.e., 8 (57.1%) males and 6 (42.8%) females, mean age 62.3 6 15.57 years. Results showed that mean recirculation rates and Kt/V did not significantly differ between the two techniques.Discussion: Because no significant difference was found between the two techniques, the direction of insertion of needles should be decided upon on a case-by-case basis depending on the anatomy of the AVF and the feasibility of the puncture.

What is the best between needles distance and direction for arteriovenous fistula cannulation in hemodialysis patients? An important yet challenging issue

“…3 Also, the results of a study by Vahedi et al 4 indicated that with placing AVF needles at a distance of 6 cm in the opposite direction, the lowest access recirculation can be occurred. Contrary to previous findings, a study by Elias et al 5 showed that there is no relationship between needle distance and direction with occurrence of access recirculation and quality of HD. They suggested that the direction of the needles should be decided from case to case, depending on the anatomy of the AVF and the possibility of puncture.…”

Relationship between arteriovenous fistula cannulation practices and dialysis adequacy: A prospective, multicenter study

“…Studies have shown contradictory results on the relationship between dialysis adequacy and the insertion direction of the fistula needle. Whereas no significant relationship was found between dialysis adequacy and the needle insertion direction in some studies (Castro et al, 2020;Elias et al, 2018;Ozmen et al, 2008), Reyes (2016) reported that needle insertion in an antegrade direction increased the Kt/V and URR values. The Kidney Disease Outcomes Quality Initiative guide reported that the fistula needle could be inserted in the antegrade or retrograde direction (Lok et al, 2020).…”

The effectiveness of instructional module on self-care practices of arteriovenous fistula among hemodialysis patients at Hail region, Saudi Arabia

“…This result not only shows unawareness of the patients about the caring process of vascular access site and the necessity for patient education in this regard but also reveals the association between the quality of self-care and the underlying diseases, number of dialysis sessions in a week, duration of using current vascular access and incidence of treated with antibiotics within 6 months duration. Experienced dialysis nurse Ann Compton estimated that about 38% (41 of 109) of patients in one of her outpatient dialysis clinics would be capable of performing incenter self-care and report that the desire to do selfcare is the most important criterion and concludes that in his center self-care patients experience significantly less morbidity and mortality (Elias et al, 2017).…”