More Nephrologist Visits Do Not Improve Dialysis Patients' AV Fistulas Outcomes: Stanford Study

Nearly every Chronic Kidney Disease and Dialysis patient knows that the type of Hemodialysis Access they have is critically important to their successful Dialysis Treatments and health outcomes both short and long term. Dialysis patients have three possible Dialysis Access options including: Catheter, Arteriovenous (AV) Graft and Arteriovenous (AV) Fistula. While some patients believe that they can help their Dialysis Access last longer with closer attention from their Nephrologists, they may be wrong based on the findings of a new Stanford University School of Medicine study. 

Recommended Reading: Chronic Kidney Disease & Diabetics, Especially Who Conduct Dialysis, Should Be On Heightened Alert

"Catheters have a greater tendency to become infected than the other access types because the device is both inside and outside of the body," according to DaVita HealthCare Partners Inc. However, AV Grafts also tend to need attention and quite a bit of upkeep to limit infections and other complications. Hence, as it relates to Hemodialysis, Leading Chronic Kidney Disease Organizations, Professionals and Experts generally agree that the AV Fistula is the best type of Vascular Access due to low rates of complications, clotting and infection as compared to the other access options.

Recommended Reading: Higher Nephrologist Caseload Linked With Earlier Deaths Of Chronic Kidney Disease Patients

An AV Fistula is the direct connection of an artery to a vein and once it is created it can technically last for decades, and in fact if it properly develops it gets bigger and stronger allowing for increased blood flow and improved Dialysis Treatments. Hence, the key to long-term success with the AV Fistula is to keep it healthy by limiting external complications such as clots, infection, or accidental damage/failure.

Recommended Reading: My Life on Dialysis: A Humorous Look

Many patients believe that increased visits with their Nephrologists alone greatly improve their chances of Vascular Access survival. However, Stanford University's newly published research suggests that this is not the case as researchers observed "no significant association between provider visits and vascular access survival." Nephrologist visits still were associated with 13% increased odds of receiving an intervention to "preserve vascular access" such as surgical, diagnostic, or endovascular (minimally invasive surgery) procedures.

Recommended Reading: Dialysis Patient's Access Improved by Stenting

The Stanford study which will be published in the Clinical Journal of the American Society of Nephrology, is not encouraging Chronic Kidney Disease patients on Dialysis to skip or avoid consultation with their Nephrologists. In fact, their research found that each additional visit per month was "associated with a 9% reduction in the odds of hospitalization for Vascular Access-related infection." What these findings highlight is the need for those who have Chronic Kidney Disease and conduct Dialysis to not rely only on their Nephrologists to preserve their Fistulas, rather use other effective strategies to ensure the longevity of their Dialysis Access. 

Tips for Chronic Kidney Disease patients to best protect their AV Fistulas include: 

1. Keeping the AV Fistula Clean. Cleanliness is one way someone on Hemodialysis can keep their fistula uninfected and reduce chances of AV Fistula complications. Look out for pain, swelling, redness and tenderness on or around your access because these are often sure signs of an infection. If caught early, Chronic Kidney Disease patients' Nephrologists can provide Antibiotics before the infection becomes too severe. 

2. Avoid clotting. Chronic Kidney Disease patients on Dialysis with an AV Fistula should know that any restriction of blood flow can cause clotting in their AV Fistula arm and ruin their access. Do not wear tight clothing or jewelry that could put pressure on your access area, do not carry bags, purses or any type of heavy item over your access area, and avoid sleeping with your access arm under your head or pillow.

3. Prevent accidental AV Fistula failure. Order your No BP/No Stick Fistula Protector Wristband by clicking here so that all Emergency Service Professionals and Healthcare Workers know not to put a blood pressure cuff or draw blood from your AV Fistula arm (use your non-access arm). 

4. Use your fingers to check the thrill (pulse) in your access daily. If the thrill changes or stops a blood clot may have formed. By immediately contacting your Healthcare Team, appropriate steps may be taken to dissolve the clot before it develops into a serious complication.

Recommended Reading: Finger Numbness Could Mean Big Problems For CKD And Diabetic Patients If Not Treated Timely

By protecting and managing the health of their AV Fistula, those with Chronic Kidney Disease who conduct Hemodialysis may enjoy a longer life and fewer complications. For more Daily Breaking News & Information about how Chronic Kidney Disease and Diabetics can better manage and improve their lives, visit every day.

Most Popular Stories:


"Complications: Arteriovenous Fistula." Http:// Mayo Foundation for Medical Education and Research.

"Complications of Arteriovenous Fistula for Hemodialysis: An 8-year Study." Http:// U.S. National Library of Medicine, National Center for Biotechnology Information.

"More Provider Visits Do Not Improve Dialysis Vascular Access Outcomes."Http:// Renal and Urology News.

"Arteriovenous (AV) Fistula — the Gold Standard Hemodialysis Access." Http:// DaVita HealthCare Partners Inc.