Should Buttonhole Cannulation of Arteriovenous Fistulas Be Used? Moderator Commentary

Agarwal, Anil

doi:10.34067/kid.0001682020

Cited by 2 publications

(2 citation statements)

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“…A higher incidence rate of 0.39 infectious events per 1000 AVF‐days associated with BHC in Australian HHD patients had already been reported 50 . The use of BHC has been fully discussed elsewhere and is still debatable, mainly because of insufficient quality studies 51–54 . In the particular setting of HHD, one major advantage of BHC is its relative ease for the self‐cannulating patient.…”

Section: Discussionmentioning

confidence: 99%

“…50 The use of BHC has been fully discussed elsewhere and is still debatable, mainly because of insufficient quality studies. [51][52][53][54] In the particular setting of HHD, one major advantage of BHC is its relative ease for the self-cannulating patient. In this study, we have no control group using rope-ladder cannulation to compare overall AVF-related infection rate; still, it is much lower than that associated with CVC.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics, practices, and outcomes in a Belgian cohort of incident home hemodialysis patients: A 6‐year experience

Vô

Anthonissen

Verger³

et al. 2022

Hemodialysis International

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Background: Home hemodialysis (HHD) remains underused in patients with kidney failure. Current literature on HHD mostly originates from non-European countries, making generalization difficult. The present study describes patients' profile and practice patterns from a Belgian HHD center, and assesses patient and technique survival and complications associated with HHD.Methods: We analyzed data from all our incident patients during a 6-year period. The patient's characteristics were summarized using descriptive statistics. Transition to another therapeutic modality, estimated using a risk model with death and transplantation as competing events, episodes of respite cares and hospitalizations, and access complications were analyzed.Results: Eighty patients (mean age: 47 years; male: 64%) met the inclusion criteria. Fifty-one percent of patients initiated dialysis with a central venous catheter (CVC) and 96% were not assisted. Arterio-venous fistula (AVF) cannulation was performed using buttonhole technique. Standard-frequent HD (47%) and short-frequent low-flow dialysate HD (34%) were mostly used at HHD initiation. Cumulative incidences of technique failure and death were 15%, 24%, and 32% at 1, 2, and 5 years. Incidence rates for respite dialysis and hospitalizations were 2.39 and 0.54 per patient-year of HHD. In comparison with AVF, incidence rate ratios of overall access complications and accessrelated infections for CVC were 4.3 (95% CI: 3.1-6, p < 0.01) and 4.4 (95% CI: 2.1-10, p < 0.01), respectively. Buttonhole cannulation was complicated by 0.26 (95% CI: 0.15-0.46) infections per 1000 AVF-days. Conclusions:This present study provides important information about patient's profile and practice patterns and safety in a cohort of 80 incident Belgian HHD patients, with encouraging techniques and patient survival. K E Y W O R D S arterio-venous fistula, buttonhole cannulation, central venous catheter, home hemodialysis, technique failure, technique survival Bernard Vô and Blaise Anthonissen contributed equally to this work.

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Section: Discussionmentioning

confidence: 99%