Document Detail


Arteriovenous fistula puncture: an essential factor for hemodialysis efficiency.
MedLine Citation:
PMID:  18925526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the blood recirculation ratio in the vascular access of patients on hemodialysis, and to calculate the Kt/Vs obtained with the different techniques of arteriovenous fistula punctures. MATERIALS AND METHODS: A total of 174 patients were divided according to the technique used for arteriovenous fistula puncture: group 1, needles in opposite directions and with a distance of 5 cm or more between them; group 2, needles in opposite directions but with a distance of less than 5 cm; group 3, unidirectional needles with both directed to the heart and with a distance of 5 cm or more; group 4, unidirectional needles but separated by a distance of less than 5 cm between needles; and group 5, patients carrying a temporary venous catheter. Blood samples were collected for urea analysis, pre and post-dialysis for Kt/V rate, and other samples for calculation of the access recirculation. RESULTS: Group 1 presented the lowest rate of access recirculation (8.51 +/- 4.90%) and the best Kt/V (1.71 +/- 0.36), while group 4 presented the worst access recirculation (20.68 +/- 4.92%) and Kt/V (1.16 +/- 0.26). All groups differed significantly from group 4 (p < 0.05), except group 5 with regard for Kt/V parameter. DISCUSSION: The technique of arteriovenous fistula puncture is an essential factor to decrease the access recirculation and assure better results of measurement of hemodialysis adequacy. On the basis of the results obtained, insertion of the needles in the same direction and with a distance of less than 5 cm between them should be avoided.
Authors:
Taísa Silva Dias; Miguel Moysés Neto; José Abrão Cardeal da Costa
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Renal failure     Volume:  30     ISSN:  1525-6049     ISO Abbreviation:  Ren Fail     Publication Date:  2008  
Date Detail:
Created Date:  2008-10-17     Completed Date:  2009-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  870-6     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Faculty of Medicine of Ribeirão Preto, São Paulo University, São Paulo, Brazil. tadias2006@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arteriovenous Anastomosis / physiopathology*,  surgery
Blood Flow Velocity / physiology
Catheterization, Peripheral*
Catheters, Indwelling
Female
Humans
Kidney Failure / physiopathology,  therapy*
Male
Middle Aged
Punctures / methods*
Regional Blood Flow / physiology*
Renal Dialysis*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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