Hemodialysis
Hemodialysis is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products (such as creatinine and urea) and extra fluids from the blood when the kidneys are not able to. Typical treatments last for 3–4 hours (sometimes up to 5 hours for larger patients) and are given three times a week.
Arteriovenous Fistula
Open surgical fistula (AVF) creation:
Medtronic Ellipsys™ (percutaneous fistula creation using thermal energy)
BD / Bard WavelinQ™ (percutaneous fistula creation using RF energy)
Phraxis InterGraft™ (surgically deployed fistula graft-stent combination)
The arteriovenous fistula (AVF, a connection that is made between an artery and a vein for dialysis access) is the currently recommended method for vascular access for hemodialysis according to the clinical practice guidelines KDOQI of the National Kidney Foundation, www.kidney.org. The procedure was invented by doctors James Cimino and M. J. Brescia at the Bronx Veterans Administration Hospital in 1966.
The arteriovenous grafts are much like fistulas in most respects, except that an artificial vessel is used to join the artery and vein. The graft usually is made of a synthetic material, often PTFE, but sometimes chemically treated, sterilized veins from animals are used. Grafts are inserted when the patient's native vasculature does not permit a fistula.
Arteriovenous Fistula Creation
Fistulas and Grafts
Events
Cardiovascular and Interventional Radiological Society of Europe (CIRSE) - September 2024, Lisbon, Portugal
American Society of Nephrology (ASN) - October 2024, San Diego, U.S.A.
Controversies in Dialysis (CIDA/EVA) - October 2024, Washington DC, U.S.A.
Paris Vascular Insights (PVI) - December 2024, Paris, France
World Congress of Nephrology (WCN) - February 2025, New Delhi, India
Vascular Access Society (VAS) - April 2025, Padova, Italy
Euro Nephrology Summit - April 2025, Paris, France
European Renal Association (ERA) - June 2025, Vienna, Austria
References
1. Bello A.K., et al., Epidemiology of haemodialysis outcomes, Nature Reviews, Nephrology, Vol 18, June 2022, 378-395
2. Himmelfarb J., et al., The current and future landscape of dialysis, Nature Reviews, Nephrology, Vol 16, Oct 2020, 573-585
3. Agarwal A.K. et al., Innovations in vascular access for hemodialysis, Kidney International (2019) 95, 1053-1063
4. Allon M., Vascular Access for Hemodialysis Patients – New Data Should Guide Decision Making, American Society of Nephrology, CJASNVol 14 June, 2019
5. Canaud B. et al., Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience, IntechOpen 2019
6. Ilie V. et al., Sutureless Microvascular Anastomosis: Literature Review, International Microsurgery Journal, 2019; 3(2):1
7. Mallios A. et al., Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System, Journal of Vascular Surgery, 2018
8. Al-Jaishi A.A. et al., Complications of the Arteriovenous Fistula: A Systematic Review, J Am Soc Nephrol 28: 1839-1850, 2017
9. Al-Balas A. et al., The Clinical and Economic Effect of Vascular Access Selection in Patients Initiating Hemodialysis with a Catheter, J Am Soc Nephrol 28: 3679-3687, 2017
10. Bream P.R. Jr., Update on Insertion and Complications of Central Venous Catheters for Hemodialysis, Thieme Medical Publishers 2016
11. Al Shakarchi J. et al., Early cannulation grafts for hemodialysis: a systematic review, J Vasc Access 2015; 16(6): 493-497
12. Ebner A. et al., Minimally Invasive Sutureless Anastomosis of an AV Hemodialysis Graft, Endovascular Today, November 2014
13. Stolic R, Most Important Chronic Complications of Arteriovenous Fistulas for Hemodialysis, Medical Principles and Practice 2013; 22:220-228
14. Foran R.F., Quinton-Scribner Cannulas for Hemodialysis – Review of Four Years’ Experience, The Western Journal of Medicine, March 1970, 112-3
15. Brescia M.J. et al., Chronic hemodialysis using venipuncture and a surgically created arterio-venous fistula, N Engl J Med. 1966; 275:1089-1092
16. Clark P.B., Routine Use of Scribner Shunt for Haemodialysis, British Medical Journal, May 1966: 1200 – 1202
17. United States Renal Data System, Annual data report, 2020, End Stage Renal Disease, Chapters 1 and 3
18. Hemodialysis patients Europe 2019
19. Hemodialysis patients Italy 2019
20. Hemodialysis patients UK – Renal Association 2019
21. Hemodialysis patients Germany 2019
22. Viart H. et al., Comparison between implantation costs of peripherally inserted central catheters and implanted subcutaneous ports, Ann Pharm Fr (2014), Elsevier Masson
23. Canaud B. et al., Global Dialysis Perspective: France, Kidney360, October 25, 2021
24. U.S. Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States, University of Michigan Health
25. Zemela M.S., et al., Real-World Usage of the WavelinQ EndoAVF System, Ann Vasc Surg. 2021 Jan; 70:116-122