Carlo Basile and colleagues from hospitals in Manduria, Italy, were among the first to recognize the relationship between vascular access flow of arteriovenous fistulas (AVFs) and cardiac output (CO). In 2008 they conducted a study to glean better insight into this rarely explored aspect of HD pathophysiology.
Jennifer MacRae and her colleagues from the University of Calgary, Calgary, Alberta, Canada, reviewed the hemodynamic and cardiovascular consequences of arteriovenous fistulas. Their findings were published in a 2006 paper in Seminars in Dialysis.
MacRae identified three periods when the presence of an AV fistula influences a patient's hemodynamics.
Lower Mortality and Dialysis Patients
Researchers found a fistula attempt could be a “surrogate marker for a healthy patient who has had good care prior to starting dialysis,” while catheters were preferred for patients who had a short life expectancy, an acute kidney injury or poor blood vessels.
The researchers also discovered that excess mortality rates in dialysis patients with catheters do not appear to be due to access-related complications but rather the result of “residual confounding, unmeasured comorbidity, or treatment selection bias.”
Frenovia Renal Research will be opening an office in Durham, North Carolina. The company is a subsidiary of Fresenius Medical Care North America and will also expand staff at its locations in New York, Illinois, Florida and Louisiana in addition to North Carolina.