Patency Rates of the Arteriovenous Fistula for Hemodialysis: A Systematic Review and Meta-analysis

Al-Jaishi, Ahmed A.; Oliver, Matthew J.; Thomas, Sonia M.; Lok, Charmaine E.; Zhang, Joyce C.; Garg, Amit X.; Kosa, Sarah Daisy; Quinn, Robert R.; Moist, Louise

doi:10.1053/j.ajkd.2013.08.023

Cited by 549 publications

(521 citation statements)

References 75 publications

Supporting

Mentioning

462

Contrasting

Unclassified

Order By: Relevance

“…Despite ongoing efforts to enhance preoperative patient evaluation and surgical planning, the primary access failure (inability to ever use it for dialysis) and primary unassisted patency (access remaining functional without an intervention) rates of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) remain unsatisfactory. The frequency of primary failure in AVFs, the vascular access of choice, is approximately 40% (1), whereas the primary unassisted patency is about 60% at 1 year after creation (2). In contrast, primary failure occurs in only approximately 20% of AVGs (3,4), but this advantage over AVFs is offset by a lower 1-year primary patency rate (30%-50%) and a threefold higher frequency of interventions to maintain functionality for dialysis (3).…”

Section: Introductionmentioning

confidence: 99%

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

Vázquez-Padrón

Allon

2016

CJASN

View full text Add to dashboard Cite

Despite significant improvements in preoperative patient evaluation and surgical planning, vascular access failure in patients on hemodialysis remains a frequent and often unforeseeable complication. Our inability to prevent this complication is, in part, because of an incomplete understanding of how preexisting venous and arterial conditions influence the function of newly created arteriovenous fistulas and grafts. This article reviews the relationship between three preexisting vascular pathologies associated with CKD (intimal hyperplasia, vascular calcification, and medial fibrosis) and hemodialysis access outcomes. The published literature indicates that the pathogenesis of vascular access failure is multifactorial and not determined by any of these pathologies individually. Keeping this observation in mind should help focus our research on the true causes responsible for vascular access failure and the much needed therapies to prevent it.

show abstract

Section: Introductionmentioning

confidence: 99%

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

Vázquez-Padrón

Allon

2016

CJASN

View full text Add to dashboard Cite

show abstract

“…This would put her at risk of complications, including bacteremia, central stenosis, and shortened ipsilateral arteriovenous access cumulative patency (32,33). Approximately 20%-60% of fistulas fail to mature (34,35) and require up to two to three interventions to facilitate maturation (36,37) (choices B and E are incorrect).…”

Section: Discussion Of Question 2amentioning

confidence: 99%

American Society of Nephrology Quiz and Questionnaire 2015: ESRD/RRT

Perazella

Choi

2016

CJASN

Self Cite

View full text Add to dashboard Cite

The Nephrology Quiz and Questionnaire remains an extremely popular session for attendees of the Annual Kidney Week Meeting of the American Society of Nephrology. During the 2015 meeting, the conference hall was once again overflowing with eager quiz participants. Topics covered by the experts included electrolyte and acid-base disorders, glomerular disease, ESRD and dialysis, and kidney transplantation. Complex cases representing each of these categories together with single best answer questions were prepared and submitted by the panel of experts. Before the meeting, training program directors of nephrology fellowship programs and nephrology fellows in the United States answered the questions through an internet-based questionnaire. During the live session, members of the audience tested their knowledge and judgment on the same series of case-oriented questions in a quiz. The audience compared their answers in real time using a cellphone application containing the answers of the nephrology fellows and training program directors. The results of the online questionnaire were displayed, and then, the quiz answers were discussed. As always, the audience, lecturers, and moderators enjoyed this highly educational session. This article recapitulates the session and reproduces selected content of educational value for the readers of the Clinical Journal of the American Society of Nephrology. Enjoy the clinical cases and expert discussions.

show abstract

“…In an ideal scenario, these changes stimulate vascular dilation and re-modeling, such that the AVF "matures," and can be used for haemodialysis. 5 Unfortunately, however, up to 60% of AVF do not mature as anticipated, 6 resulting in unacceptable patient morbidity and a significant burden on healthcare expenditure. A major cause of AVF failure is the formation of stenotic regions due to development of Intimal Hyperplasia (IH) in the juxta-anastomotic area and the vein.…”

Section: Introductionmentioning

confidence: 99%

Suppressing unsteady flow in arterio-venous fistulae

et al. 2017

View full text Add to dashboard Cite

Arterio-Venous Fistulae (AVF) are regarded as the “gold standard” method of vascular access for patients with end-stage renal disease who require haemodialysis. However, a large proportion of AVF do not mature, and hence fail, as a result of various pathologies such as Intimal Hyperplasia (IH). Unphysiological flow patterns, including high-frequency flow unsteadiness, associated with the unnatural and often complex geometries of AVF are believed to be implicated in the development of IH. In the present study, we employ a Mesh Adaptive Direct Search optimisation framework, computational fluid dynamics simulations, and a new cost function to design a novel non-planar AVF configuration that can suppress high-frequency unsteady flow. A prototype device for holding an AVF in the optimal configuration is then fabricated, and proof-of-concept is demonstrated in a porcine model. Results constitute the first use of numerical optimisation to design a device for suppressing potentially pathological high-frequency flow unsteadiness in AVF.

show abstract

Patency Rates of the Arteriovenous Fistula for Hemodialysis: A Systematic Review and Meta-analysis

Cited by 549 publications

References 75 publications

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

New Insights into Dialysis Vascular Access: Impact of Preexisting Arterial and Venous Pathology on AVF and AVG Outcomes

American Society of Nephrology Quiz and Questionnaire 2015: ESRD/RRT

Suppressing unsteady flow in arterio-venous fistulae

Contact Info

Product

Resources

About