title: Safety of arteriovenous fistulae and grafts for continuous renal replacement therapy: The Michigan experience.
abstract: Arteriovenous fistula or graft (AVF/AVG) use is widely considered contraindicated for continuous renal replacement therapy (CRRT), yet insertion of hemodialysis (HD) catheters can carry high complication risk in critically ill end-stage renal disease (ESRD) patients.
  
  
  
  Single-center analysis of 48 consecutive hospitalized ESRD patients on maintenance HD who underwent CRRT using AVF/AVG from 2012 to 2013. Primary outcome was access-related complications.
  
  
  
  Mean age was 60 years, 48% were male, and 88% required vasopressor support. Median duration of AVF/AVG use for CRRT was 4 days (range 1-34). Ten (21%) patients had access complications (5 bleeding, 5 infiltration, 1 thrombosis); 5 (10.4%) required catheter placement. Overall 31 (65%) patients survived to hospital discharge and AVF/AVG access was functional at the time of discharge in 29 (94%) patients.
  
  
  
  In our experience, use of AVF/AVG for CRRT can be performed with a low serious complication rate and low risk of access loss, potentially avoiding catheter-related complications.
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.|Division of Nephrology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Anas
authors.initials: A
authors.lastname: Al Rifai
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.|Division of Nephrology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Sukul
authors.affiliation: Department of Medical Informatics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Wonnacott
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.|Division of Nephrology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Heung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000628:therapy*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D017582:Renal Replacement Therapy / Q000379:methods*
keywords: CRRT; arteriovenous fistula; arteriovenous graft; patient safety