title: Arteriovenous fistula toxicity.
abstract: The arteriovenous fistula (AVF) has been a mainstay of hemodialysis treatments and the preferred access route since its inception in the 1960s, due to its longevity and resistance to infection. However, the AVF is not benign. There is significant primary failure, as well as cardiac, vascular, and other, less well recognized, complications. Together, they represent toxicity, to which considerable morbidity and mortality can be attached. Official policy, based on guidelines where AVF toxicity is given short shrift, drives an increase in use of these devices, and may have undesired consequences.
authors.affiliation: Department of Internal Medicine-Nephrology, Vivantes Klinikum im Friedrichshain, Berlin, Germany. ramerlin@chpnet.org
authors.forename: Richard
authors.initials: R
authors.lastname: Amerling
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Martin
authors.initials: M
authors.lastname: Kuhlman
authors.forename: James F
authors.initials: JF
authors.lastname: Winchester
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000601:surgery; D007022:Hypotension / Q000601:surgery; D006435:Renal Dialysis / Q000009:adverse effects* / Q000401:mortality