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We Refuse to Give up on Nonmaturing Fistulas
Author(s) -
Beathard Gerald A.
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12511
Subject(s) - medicine , dialysis , central venous catheter , arteriovenous fistula , catheter , incidence (geometry) , intensive care medicine , dialysis catheter , fistula , surgery , venous access , physics , optics
The nonmaturing arteriovenous fistula (AVF) is a major problem and can lead to significant patient morbidity and mortality because the patient is exposed to the risk of dialysis with a central venous catheter (CVC). Access planning should include a strategy to decrease the incidence of AVF nonmaturation. All newly created AVFs should be evaluated for maturation at 4–6 weeks. If it is judged to not be usable at that time, it should be evaluated for salvage. However, if multiple procedures over a prolonged period of time are necessary for salvage, the decreasing chances of long‐term success with the increasing risks of CVC‐based dialysis must be considered. Giving up on the nonmaturing AVF may be in the best interest of the patient.