Universität zu Köln

Matoussevitch, V., Gawenda, M., Konner, K., Taylan, C., Kuhr, K., Reichert, V., Hoppe, B. and Brunkwall, J. (2015). Native dialysis shunts in children and adolescents. A single center analysis. Gefasschirurgie, 20 (1). S. 32 - 39. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1434-3932

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Abstract

Introduction. Even though early transplantation is still the first line therapy in pediatric and adolescent patients with end-stage renal disease (ESRD), up to 30% still require hemodialysis (HD) therapy. Creating an arteriovenous fistula (AVF) is challenging, particularly in small infants which is why catheters are frequently used in pediatric patients. This article describes experiences with the creation of AVFs which currently allows in-dwelling catheters to be completely avoided in children and adolescents on HD. Materials and methods. During the 59-month-period from January 2009 to December 2013 there were 34 patients rated as unsuitable for transplantation for at least the upcoming 6 months or who had already started HD therapy using a central venous catheter (CVC) some months previously. Of these patients 3 were aged between 12 and 36 months, weighed 9-12 kg and received HD treatment through a cuffed, tunnelled CVC via the jugular vein. The other 31 patients were 6-19 years of age and were assigned to receive the alternative AV fistula. Results. During the 59-month time period 31 patients were provided with 32 AVFs, 26 received a peripheral radiocephalic fistula, 5 a Gracz type fistula and 1 a brachiobasilic fistula. All but two fistulae matured primarily within an average time of 45 (range 16-191) days until the first cannulation. The 12-month primary patency and primary assisted patency rates of the fistulas were 78% and 94%, respectively. Conclusion. The creation of native vascular accesses is an effective and reliable procedure in pediatric and adolescent patients. It allows central venous catheters to be avoided and should be used for long term hemodialysis treatment as well as a bridging procedure until renal transplantation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Matoussevitch, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gawenda, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Konner, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Taylan, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reichert, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoppe, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-413928
DOI:	10.1007/s00772-014-1446-3
Journal or Publication Title:	Gefasschirurgie
Volume:	20
Number:	1
Page Range:	S. 32 - 39
Date:	2015
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1434-3932
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41392