January 1, 2007Seminars in Dialysis

ASDIN Original Investigations: Inflow Reduction by Distalization of Anastomosis Treats Efficiently High‐Inflow High‐Cardiac Output Vascular Access for Hemodialysis

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Why the study?

Does inflow reduction by distalization of anastomosis reduce access inflow and cardiac output in hemodialysis patients with high-inflow fistulas and heart failure?

Population

17 hemodialysis patients with symptoms of heart failure and a fistula inflow rate above 1600 ml/min.

Design

Case_series

Authors

ECEric S. ChemlaSt George’s University Hospitals NHS Foundation Trust MMMohamed A. MorsyKing Faisal University LALiz AndersonSt George’s University Hospitals NHS Foundation Trust

Discussion

Member takes

Implication

May support distalization in select high-flow access HF cases; leaves open need for controlled trials.

Structured PICO

Does inflow reduction by distalization of anastomosis reduce access inflow and cardiac output in hemodialysis patients with high-inflow fistulas and heart failure?

Population

17 hemodialysis patients (10 men, 7 women) with symptoms of heart failure and a fistula inflow rate above 1600 ml/min (15 brachiocephalic fistulas, 2 brachioaxillary bypass grafts).

Intervention

Inflow reduction procedure consisting of ligation of the brachial anastomosis and reconstruction of the fistula using an expanded polytetrafluoroethylene vascular graft in a bypass from the radial artery.

Outcome

Access inflow rate and cardiac output ratesurrogate

Inflow reduction by distalization of the anastomosis effectively reduces access inflow and cardiac output, resolving heart failure symptoms while preserving vascular access in hemodialysis patients.

Limitations

Small sample size
Need for longer follow-up studies

Cite This Study

Chemla et al. (2007) studied this question.

synapsesocial.com/papers/6a87a356a9eb41bcdfc4d6e4 https://doi.org/10.1111/j.1525-139x.2007.00244.x

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ASDIN Original Investigations: Inflow Reduction by Distalization of Anastomosis Treats Efficiently High‐Inflow High‐Cardiac Output Vascular Access for Hemodialysis

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

ASDIN Original Investigations: Inflow Reduction by Distalization of Anastomosis Treats Efficiently High‐Inflow High‐Cardiac Output Vascular Access for Hemodialysis

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider