Abstract
Fistula maturation is fundamental to dialysis success. Arteriovenous fistula (AVF) maturation is considered clinically successful, if 6 weeks after surgery, the fistula supports a flow of 600 ml/min, is located at a maximum of 6 mm from the skin surface, and has a diameter of at least 6 mm. This chapter discusses fistula maturation and management of the immature fistula.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis. 2006;48 Suppl 1:S176–247.
Nassar GM, Nguyen B, Rhee E, Achkar K. Endovascular treatment of the “failing to mature” arteriovenous fistula. Clin J Am Soc Nephrol. 2006;1:275–80.
Clark TW, Cohen RA, Kwak A, Markmann JF, et al. Salvage of nonmaturing native fistulas by using angioplasty. Radiology. 2007;242:286–92.
Schild AF, Prieto J, Glenn M, Livingstone J, et al. Maturation and failure rates in a large series of arteriovenous dialysis access fistula. Vasc Endovascular Surg. 2004;38:449–53.
Dember LM, Beck GJ, Allon M, Delmez JA, Dixon BS, Greenberg A, Himmelfarb J, Vazquez MA, Gassman JJ, Greene T, Radeva MK, Braden GL, Ikizler TA, Rocco MV, Davidson IJ, Kaufman JS, Meyers CM, Kusek JW. Feldman HI, for the Dialysis Access Consortium Study G: effect of clopidogrel on early failure of arteriovenous fistulas for hemodialysis: a randomized controlled trial. JAMA. 2008;299:2164–71.
Dixon BS. Why don’t fistulas mature? Kidney Int. 2006;70:1413–22.
Asif A, Roy-Chaudhury P, Beathard GA. Early arteriovenous fistula failure: a logical proposal for when and how to intervene. Clin J Am Soc Nephrol. 2006;1:332–9.
Dixon BS, Novak L, Fangman J. Hemodialysis vascular access survival: upper-arm native arteriovenous fistula. Am J Kidney Dis. 2002;39:92–101.
Ishani A, Collins AJ, Herzog CA, Foley RN. Septicemia, access and cardiovascular disease in dialysis patients: the USRDS Wave 2 study. Kidney Int. 2005;68:311–8.
Lok CE. Fistula first initiative: advantages and pitfalls. Clin Am J Kidney Dis. 2007;2:1043–53.
Maya ID, Oser R, Saddekni S, Baker J, Allon M. Vascular access stenosis: comparison of arteriovenous grafts and fistula. Am J Kidney Dis. 2004;44:859–65.
Collins A, Foley R, Herzog C, et al. US Renal Data System 2013 Annual Data Report. Am J Kidney Dis. 2009;53:1–374.
Rus RR, Ponikvar R, Kenda BB, Buturović-Ponikvar J. Effect of local physical training on the forearm arteries and veins in patients with end-stage renal disease. Blood Purif. 2003;21:389–94.
Oder TF, Teodo Rescu V, Uribarri J. Effect of exercise on the diameter of arteriovenous fistulae in hemodialysis patients. ASAIO J. 2003;49:554–5.
Beathard GA, Arnold P, Jackson J, Lichfield T. Aggressive treatment of early fistula failure. Kidney Int. 2003;64:1487–94.
Asif A, Leon C, Orozco-Vargas LC, Krishnamurthy G, Choi KL, Mercado C, Merrill D, Thomas I, Salman L, Artikov S, Bourgoignie JJ. Accuracy of physical examination in the detection of arteriovenous fistula stenosis. Clin J Am Soc Nephrol. 2007;2:1191–4.
Turmel-Rodrigues L, Mouton A, Birmelé B, et al. Salvage of immature forearm fistulas for haemodialysis by interventional radiology. Nephrol Dial Transplant. 2001;16(12):2365–71.
Falk A. Maintenance and salvage of arteriovenous fistulas. J Vasc Interv Radiol. 2006;17(5):807–13.
Turmel-Rodrigues L, Boutin JM, Camiade C, Brillet G, Fodil-Cherif M, Mouton A. Percutaneous Dilation of the radial artery in nonmaturing autogenous radial – cephalic fistulas for haemodialysis. Nephrol Dial Transplant. 2009;24:3782–8.
Asif A, Cherla G, Merrill D, et al. Venous mapping using venography and the risk of radiocontrast – induced nephropathy. Semin Dial. 2005;18:239–42.
Lee T, Tindni A, Roy-Chaudhury P. Improved cumulative survival in fistulas requiring surgical interventions to promote fistula maturation compared with endovascular interventions. Semin Dial. 2013;26(1):85–9.
Long B, Brichart N, Lermusiaux P, Turmel-Rodrigues L, Artru B, Boutin JM, Pengloan J, Bertrand P, Bruyere F. Management of perianastomotic stenosis of direct wrist autogenous radial-cephalic arteriovenous accesses for dialysis. J Vasc Surg Off Publ Soc Vasc Surg Int Soc Cardiovasc Surg N Am Chap. 2011;53:108–14.
Tessitore N, Mansueto G, Lipari G, Bedogna V, Tardivo S, Baggio E, Cenzi D, Carbognin G, Poli A, Lupo A. Endovascular versus surgical preemptive repair of forearm arteriovenous fistula juxta-anastomotic stenosis: analysis of data collected prospectively from 1999 to 2004. Clin J Am Soc Nephrol. 2006;1:448–54.
Lipari G, Tessitore N, Poli A, Bedogna V, Impedovo A, Lupo A, Naggio E. Outcomes of surgical revisions of stenosed and thrombosed forearm arteriovenous fistulae for haemodialysis. Nephrol Dial Transplant. 2007;22:2605–12.
Miller GA, Goel N, Khariton A, et al. Aggressive approach to salvage non-maturing arteriovenous fistulae: a retrospective study with follow-up. J Vasc Access. 2009;10:183–91.
Sammett EJ, Hastie J, Chopra PR, Pradhan S, Ahmad I, Chiramel T, Joseph R. Augmented balloon-assisted maturation (aBAM) for nonmaturing dialysis arteriovenous fistula. J Vasc Access. 2011;12:9–12.
Voormolen EHJ, Johrome AK, Bartels LW, et al. Nonmaturation of arm arteriovenous fistulas for hemodialysis access: a systematic review of risk factors and results of early treatment. J Vasc Surg. 2009;49:325–36.
Lee T, Ullah A, Allon M, Succop P, El-Khtib M, Munda R, Roy-Chaudhury P. Decreased cumulative access survival in arteriovenous fistulas requiring interventions to promote maturation. Clin J Am Soc Nephrol. 2011;6:575–81.
Konner K, Nonast-Daniel B, Ritz E. The arteriovenous fistula. J Am Soc Nephrol. 2003;14:1669–80.
Krishnamoorthy MK, Banerjee RK, Wang Y, Zhang J, Roy AS, Khoury SF, Arend LJ, Rudich S, Roy-Chaudhury P. Hemodynamic wall shear stress profiles influence the magnitude and pattern of stenosis in a pig AV Fistula. Kidney Int. 2008;74:1410–9.
Remuzzi A, Ene-Iordache B. Novel paradigms for dialysis vascular access: upstream hemodynamics and vascular remodeling in dialysis access stenosis. Clin Am J Kidney Dis. 2013;8:2186–93.
Yang B, Janardhanan R, Vohra P, Greene EL, Bhattacharya S, Withers S, Roy B, Nieves Torres E, Mandrekar J, Leof EB, Mukhopadhyay D, Misra S. Adventitial transduction of lentivirus – shRNA-VEGF-A treatment in arteriovenous fistula reduces venous stenosis formation. Kidney Int. 2014;85:289–306.
Simone S, Loverre A, Cariello M, Divella C, Castellano G, Gesualdo L, Pertosa G, Grandaliano G. Arteriovenous fistula stenosis in hemodialysis patients is characterized by an increased adventitial fibrosis. J Nephrol. 2014;27:27.
Singh TM, Sbe KY, Saski T, Zhuang YJ, Masuda H, Zarins CK. Basic fibroblast growth factor expression precedes flow – induced arterial enlargement. J Surg Res. 1998;77(165).
Jiang Z, Yu P, Tao M, Fernandez C, Ifantides C, Moloye O, Schultz GS, Ozaki CK, Berceli SA. TGF – B – and CTGF – mediated fibroblast recruitment influences early outward vein graft remodeling. Am J Physiol Heart Cire Physiol. 2007;293:H482–8.
Caplice NM, Wang S, Tracz M, Croatt AJ, Grande JP, Katusic ZS, Nath KA. Neoangiogenesis and the presence of progenitor cells in the venous limb of an arteriovenous fistula in the rat. Am J Physiol Renal Physiol. 2007;293:F470–5.
Skartsis N, Martinez L, Duque JC, Tabbara M, Velazquez OC, Asif A, Andreopoulos F, Salman LH, Vazquez-Padron RI. C-Kit signaling determines neointimal hyperplasia in arteriovenous fistulae. Am J Physiol Renal Physiol. 2014;307:F1095–104.
Wong CY, Rithuizen TC, de Vries MR, Rabelink TJ, Hamming JF, van Zonneveld AJ, Quax PH, Rotmans JI. Elastin is a key regulator of outward remodeling in arteriovenous fistulas. Eur J Vasc Endovasc Surg. 2015;49:480–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Klinger, D. (2017). The Immature Arteriovenous Fistula. In: Shalhub, S., Dua, A., Shin, S. (eds) Hemodialysis Access. Springer, Cham. https://doi.org/10.1007/978-3-319-40061-7_27
Download citation
DOI: https://doi.org/10.1007/978-3-319-40061-7_27
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-40059-4
Online ISBN: 978-3-319-40061-7
eBook Packages: MedicineMedicine (R0)