Should Buttonhole Technique In Chronic Kidney Disease Patients On Hemodialysis Be Discontinued?

discontinuing buttonhole.jpg

Vascular access Cannulating (puncturing your Ateriovenous Venous Fistula) is among the more difficult aspects of Hemodialysis (HD). However, many patients have discovered that the Buttonhole Technique (using dull needles) can make AV Fistula cannulation more bearable and less painful. Although in the past, the Buttonhole Technique was preferred, recent studies have taken aim at the process. The Clinical Journal of the American Society of Nephrology published a study on January 2014 stating that, "The relative merits of buttonhole (or blunt needle) versus rope ladder (or sharp needle) cannulation for Hemodialysis vascular access are unclear."    

Recommended Reading: Suggestions to avoid problems with Buttonhole for CKD Population

Many people find the use of sharp needles to be more painful during treatment than needles that are blunt. Further, many have successfully used the Buttonhole Technique for years without incident. However, the American Society of Nephrology study found that the use of buttonholes in HD patients were associated with a "significantly higher" rate of total Arteriovenous Fistula infections. Hence, many professionals are now recommending discontinuing the Buttonhole Technique for the preferred Rope Ladder Technique. 

Recommended Reading: Obstruction in AV Fistula can cause Dialysis Patients to Lose Fingers or even a Hand

The Rope Ladder Technique is the most frequently used cannulation method in the United States and rotates the needle placement sites each time you conduct dialysis. Using this method your needle, which will be sharp, should be 1 1/2 to 2 inches from the last puncture site. It has been found that Rope Ladder can help expand the lifespan of your fistula. Changing cannulation sites give the previous needle site time to heal, prevents aneurysms from forming, and reduces risk of infection.

Recommended Reading: CKD on Dialysis should make checking Fistula "Buzz" a Daily Practice

Still many prefer the buttonhole method because using the same site often is easier and re-sticking with a sharp needle is infrequent. Current buttonhole users had far fewer bruises and infiltrations as well as a decrease in anxiety related to needle placement. Some have noted that by applying Lidocaine cream and removing their scab with needle nose tweezers, rather than "digging it off," they have had fewer infections related to their buttonhole. 

Recommended Reading: Things Chronic Kidney Disease Patients Aren't Doing Maybe Killing Chances To Prolong Their Life-Line

Clearly, HD patients are all different so you should discuss with your Nephrologists which cannulation technique is best for you given these new found risks. KidneyBuzz.com is a daily news resource that you can turn to for tailored, breaking news related to dialysis, Chronic Kidney Disease and Diabetes. Support us by purchasing our new Life Management and Diet Guide called Fight Kidney Disease and Diabetes. Without your support and viewership, we could not provide this information to you every day, for that we are both humbled and grateful. Take advantage of the free February Newsletter by signing up at contact@kidneybuzz.com, and remember to view each obstacle and set back as an opportunity for you to grow and become more resilient.

You can now get a Valentine's Day card at KidneyBuzz.com which promotes Kidney Donor awareness, that you can send to your friends and loved ones. Click Here.

You can now get a Valentine's Day card at KidneyBuzz.com which promotes Kidney Donor awareness, that you can send to your friends and loved ones. Click Here.

KIDNEYBUZZ.COM'S NEW DIET GUIDE FOR INDIVIDUALS SUFFERING WITH CHRONIC KIDNEY DISEASE  AND DIABETES CONTAINS MANY QUICK, EASY-TO-MAKE, AND TRULY DELICIOUS RECIPES.  YOU WILL ALSO GET CREATIVE LIFE MANAGEMENT TIPS WHILE SUPPORTING THE DAILY TAILORED NEWS COVERAGE BY PURCHASING THIS VOLUME FOR ONLY $10.00.CLICK HERE.

KIDNEYBUZZ.COM'S NEW DIET GUIDE FOR INDIVIDUALS SUFFERING WITH CHRONIC KIDNEY DISEASE  AND DIABETES CONTAINS MANY QUICK, EASY-TO-MAKE, AND TRULY DELICIOUS RECIPES.  YOU WILL ALSO GET CREATIVE LIFE MANAGEMENT TIPS WHILE SUPPORTING THE DAILY TAILORED NEWS COVERAGE BY PURCHASING THIS VOLUME FOR ONLY $10.00.CLICK HERE.

PURCHASE YOUR $5.00 "NO BLOOD PRESSURE (BP)/NO NEEDLE STICK (STICK)" MEDICAL ALERT BRACELET TO PROTECT YOUR FISTULA FROM FAILURE AND SUPPORT KIDNEYBUZZ.COM. CLICK HERE.

PURCHASE YOUR $5.00 "NO BLOOD PRESSURE (BP)/NO NEEDLE STICK (STICK)" MEDICAL ALERT BRACELET TO PROTECT YOUR FISTULA FROM FAILURE AND SUPPORT KIDNEYBUZZ.COM. CLICK HERE.

Most Popular Stories:

Harvard University Moving Toward Ending Dialysis As Chronic Kidney Disease Patients Know It
New Health Challenges Facing Chronic Kidney Disease Patients: How To Successfully Cope
Some Dialysis Patients Say they are Uncomfortable raising concerns with their healthcare team

References: 

Buttonhole cannulation and clinical outcomes in a home hemodialysis cohort and systematic review., Muir CA, Kotwal SS, Hawley CM, Polkinghorne K, Gallagher MP, Snelling P, Jardine MJ., Clin J Am Soc Nephrol. 2014.

"Believing in the Buttonhole Technique." Http://www.nephrologynews.com/. Nephrology News and Issues.

"Rope Ladder and Constant Site or Buttonhole Techniques." Http://www.davita.com/. DaVita HealthCare Partners Inc.