To the Editor: The article on home haemodialysis by Agar and colleagues describes a changing pattern of practice that has seen many patients enjoy the freedom of dialysing at night in their home environment.1 One consideration not mentioned is the need for appropriate vascular access. For a patient to engage in self-cannulation, a fistula needs to be created for ease of use. This requires a few imperatives in fistula design to be met.
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- Geelong Vascular Service, Geelong, VIC.
- 1. Agar JW, Hawley CM, George CR, et al. Home haemodialysis in Australia — is the wheel turning full circle? Med J Aust 2010; 192: 403-406. <MJA full text>
- 2. Dhingra RK, Young EW, Hulbert-Shearon TE, et al. Type of vascular access and mortality in US hemodialysis patients. Kidney Int 2001; 60: 1443-1451.
- 3. Ascher E, Gade P, Hingorani A, et al. Changes in the practice of angioaccess surgery: impact of dialysis outcome and quality initiative recommendations. J Vasc Surg 2000; 31: 84-92.
- 4. Kherlakian GM, Roedersheimer LR, Arbaugh JJ, et al. Comparison of autogenous fistula versus expanded polytetrafluoroethylene graft fistula for angioaccess in hemodialysis. Am J Surg 1986; 152: 238-243.
- 5. Sidawy AN, Spergel LM, Besarab A, et al. The Society for Vascular Surgery: clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access. J Vasc Surg 2008; 48 (5 Suppl): 2S-25S.