Over 95% of Chronic Kidney Disease patients who must undergo Dialysis because of Renal Failure choose some form of Hemodialysis (In-Center, Home, or Nocturnal) over its Peritoneal Dialysis counterpart. To conduct Hemodialysis, Chronic Kidney Disease patients are required to have a surgically created Arteriovenous (AV) Fistula for treatment. Do you use an AV Fistula?
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Cardiovascular (Heart) Disease is well-recognized to be the leading contributor of mortality (death) in people with Chronic Kidney Disease, and many believe that this is due to diet, lack of exercise in Chronic Kidney Disease patients, and the process of Dialysis itself. While these may be factors, several studies are beginning to suggest that the development and use of an AV Fistula may be an underappreciated, but very real contributor to Cardiovascular related deaths in this population.
These findings may be very startling for many with an AV Fistula which is often considered to be the "Gold Standard" for Dialysis. Hence, let's understand why your "lifeline" (AV Fistula) may be a major contributing factor to serious health complications. Since your blood flows quicker through an AV Fistula than it would if your blood flowed through a normal course of arteries (capillaries and veins) your heart pumps harder to compensate for the drop in blood pressure. Over time, the increased intensity of your heart's pumping can weaken your heart muscle, causing heart failure. "This is the most serious complication of AV Fistulas," suggested the Mayo Clinic.
Although most agree that the AV Fistula has a detrimental effect on heart function, the exact role is less clear. It is assumed that the construction of an AV Fistula increases heart pumping by 15%. Individual results in small studies of patients indicate that this leads to serious complications or death in approximately 12.2% and 17% of Dialysis patients, according to the journal, Medical Principles and Practice.
What can you do? Check for the signs of high-output Heart Failure including significantly increased heart rates (tachycardia), and elevated pulse pressure. Routine access flow monitoring which is conducted by your Healthcare Team should identify issues, but be sure to bring any concerns you may have to their attention. In serious cases, your AV Fistula may have to be closed to correct the issue, but in most cases this can be avoided.
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Most Popular Readings:
"Heart Failure and Hemodialysis Arteriovenous Fistulae." Http://www.uptodate.com/. Wolters Kluwer Health.
"National Center for Biotechnology Information." Http://www.ncbi.nlm.nih.gov/. U.S. National Library of Medicine.
"Arteriovenous Fistula." Http://www.mayoclinic. Mayo Foundation for Medical Education and Research.