Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jul;36(7):1739-1749.
doi: 10.1007/s00467-020-04746-6. Epub 2020 Oct 15.

Update on the creation and maintenance of arteriovenous fistulas for haemodialysis in children

Evgenia Preka  1 , Rukshana Shroff  2 , Lynsey Stronach  2 , Francis Calder  2   3 , Constantinos J Stefanidis  4
Affiliations
Review

Update on the creation and maintenance of arteriovenous fistulas for haemodialysis in children

Evgenia Preka et al. Pediatr Nephrol. 2021 Jul.

Abstract

Arteriovenous fistulas (AVFs) are widely used for haemodialysis (HD) in adults with stage 5 chronic kidney disease (CKD 5) and are generally considered the best form of vascular access (VA). The 'Fistula First' initiative in 2003 helped to change the culture of VA in adults. However, this cultural change has not yet been adopted in children despite the fact that a functioning AVF is associated with lower complication rates and longer access survival than a central venous line (CVL). For children with CKD 5, especially when kidney failure starts early in life, there is a risk that all VA options will be exhausted. Therefore, it is essential to develop long-term strategies for optimal VA creation and maintenance. Whilst AVFs are the preferred VA in the paediatric population on chronic HD, they may not be suitable for every child. Recent guidelines and observational data in the paediatric CKD 5 population recommend switching from a 'Catheter First' to 'Catheter Last' approach. In this review, recent evidence is summarized in order to promote change in current practices.

Keywords: Arteriovenous fistula; Children; Paediatric haemodialysis; Vascular access.

PubMed Disclaimer

References

    1. Borzych-Duzalka D, Shroff R, Ariceta G, Yap YC, Paglialonga F, Xu H, Kang HG, Thumfart J, Aysun KB, Stefanidis CJ, Fila M, Sever L, Vondrak K, Szabo AJ, Szczepanska M, Ranchin B, Holtta T, Zaloszyc A, Bilge I, Warady BA, Schaefer F, Schmitt CP (2019) Vascular access choice, complications, and outcomes in children on maintenance hemodialysis: findings from the International Pediatric Hemodialysis Network (IPHN) Registry. Am J Kidney Dis 74:193–202. https://doi.org/10.1053/j.ajkd.2019.02.014 - DOI - PubMed
    1. Shroff R, Calder F, Bakkaloğlu S, Nagler EV, Stuart S, Stronach L, Schmitt CP, Heckert KH, Bourquelot P, Wagner AM, Paglialonga F, Mitra S, Stefanidis CJ, European Society for Paediatric Nephrology Dialysis Working Group (2019) Vascular access in children requiring maintenance haemodialysis: a consensus document by the European Society for Paediatric Nephrology Dialysis Working Group. Nephrol Dial Transplant 34:1746–1765. https://doi.org/10.1093/ndt/gfz011 - DOI - PubMed
    1. Boehm M, Bonthuis M, Noordzij M, Harambat J, Groothoff JW, Melgar ÁA, Buturovic J, Dusunsel R, Fila M, Jander A, Koster-Kamphuis L, Novljan G, Ortega PJ, Paglialonga F, Saravo MT, Stefanidis CJ, Aufricht C, Jager KJ, Schaefer F (2019) Hemodialysis vascular access and subsequent transplantation: a report from the ESPN/ERA-EDTA Registry. Pediatr Nephrol 34:713–721. https://doi.org/10.1007/s00467-018-4129-6 - DOI - PubMed
    1. https://www.usrds.org/2019/download/USRDS_2019_ES_final.pdf , Accessed 09 June 2020
    1. Basile C, Lomonte C (2007) The operating surgeon is the major determinant for a successful arteriovenous fistula maturation. Kidney Int 72:772. https://doi.org/10.1038/sj.ki.5002206 - DOI - PubMed

MeSH terms

LinkOut - more resources