title: Successful vascular access management for home haemodialysis: a practical approach.
abstract: BACKGROUND
  The literature in the field of access management in relation to home haemodialysis (HHD) was reviewed.
  
  
  RESULTS
  One of the greatest benefits of HHD is the possibility for high dose dialysis. There is, however, concern about its adverse effects on access survival. Furthermore, for the patients, self-cannulation is often the biggest obstacle for HHD. Both problems might be resolved by applying a single needle dialysis technique or, in case of arterio-venous fistulae, using the buttonhole (BH) method. As for the BH method there is one limitation-the elevated risk of life-threatening infections. However, in none of the trials referred to in this paper, the BH method was abandoned, probably due to the implementation of successful, problem-tackling measures.
  
  
  CONCLUSIONS
  Continued training and re-training of staff and patients is vital to gain and maintain a wide understanding of successful vascular access management.
authors: Dianet Dialysis Centers, Brennerbaan 130, Utrecht, The Netherlands. a.verhallen@dianet.nl
authors: Annemarie
authors: A
authors: Verhallen
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000379:methods / Q000451:nursing* / Q000523:psychology; D055499:Catheter-Related Infections / Q000451:nursing / Q000517:prevention & control; D006437:Hemodialysis, Home / Q000379:methods / Q000451:nursing* / Q000523:psychology; D006801:Humans; D007318:Inservice Training; D007676:Kidney Failure, Chronic / Q000451:nursing* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010353:Patient Education as Topic; D012307:Risk Factors; D012648:Self Care / Q000379:methods / Q000523:psychology; D006113:United Kingdom