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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...

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Related Experiment Video

Updated: Jun 27, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
07:30

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Published on: April 1, 2022

[Vascular access for dialysis in elderly: AVF versus permanent CVC].

G Brunori1, A Bandera, F Valente

  • 1S.C. di Nefrologia e Dialisi, Presidio Ospedaliero Santa Chiara, Azienda Provinciale per i Servizi Sanitari, Largo Medaglie d'Oro 8, Trento, Italy. gcbrunori@hotmail.com

Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
|December 3, 2008
PubMed
Summary

Choosing the right hemodialysis vascular access is crucial for patient outcomes. Native fistulas are preferred, even in elderly patients, to minimize complications associated with grafts and catheters.

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Last Updated: Jun 27, 2026

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Medical Devices

Background:

  • Vascular access type significantly impacts hemodialysis outcomes and patient morbidity/mortality.
  • Complications associated with vascular access can negatively affect patient health.
  • The Cimino Brescia fistula is the preferred vascular access, followed by grafts, while tunneled central venous catheters are a 'second choice' due to higher complication rates.

Purpose of the Study:

  • To evaluate the effectiveness of different hemodialysis vascular access types.
  • To assess the suitability of arteriovenous fistulas (AVFs) in elderly patients.
  • To guide the selection of optimal vascular access to reduce complications.

Main Methods:

  • Review of existing literature on hemodialysis vascular access.
  • Analysis of complication rates associated with fistulas, grafts, and catheters.
  • Consideration of instrumental tests like echo-color Doppler and angiography for vascular bed assessment in elderly patients.

Main Results:

  • Native fistulas are ideal, followed by grafts; catheters present higher risks of thrombosis and infection.
  • Elderly patients' vascular beds may be compromised, but AVFs can often still be created successfully.
  • Age alone should not preclude AVF creation in suitable elderly patients.

Conclusions:

  • Optimal patient and site selection by nephrologists and vascular surgeons is key to successful vascular access.
  • Limiting the use of 'second choice' accesses like central catheters can improve patient outcomes.
  • Elderly patients can benefit from AVFs, challenging the notion that age limits access options.