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Semin intervent Radiol 2004; 21(2): 105-110
DOI: 10.1055/s-2004-833683
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Medical Complications in Hemodialysis Patients Requiring Vascular Access Radiology Procedures

Mary S. Hammes1
  • 1Assistant Professor of Medicine, Department of Medicine, Division of Nephrology, University of Chicago Hospitals, Chicago, Illinois
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Publication History

Publication Date:
13 September 2004 (online)

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Vascular access maintenance is crucial to providing adequate hemodialysis (HD) and hence preventing signs and symptoms of uremia. The best vascular assess is a permanent arteriovenous fistula (AVF) because it has the longest survival with the least number of complications. However, because of problems with AVF maturation, the majority of HD in the United States is provided via an arteriovenous graft (AVG) or tunneled cuffed central venous catheter. The most common access complications include infection and thrombosis. For these reasons, a patient is often referred to interventional radiology for a procedure such as a catheter placement, change, or a thrombectomy with angioplasty and/or stent placement. Commonly, a HD patient will present after missing a dialysis session. This might predispose the patient to further complications. This review is intended to provide insight into some of the common medical problems (infectious, hematologic, and cardiac) facing a HD patient as a consequence of uremia. Increased awareness to these medical issues provides guidance to prevent unnecessary complications in this difficult patient population.

KEYWORDS

Hemodialysis - vascular access - interventional radiology - bacteremia - coagulation

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Mary S HammesD.O. 

Assistant Professor of Medicine, Department of Medicine, Division of Nephrology, University of Chicago Hospitals

S511, MC 5100, 5841 S. Maryland Ave.

Chicago, IL 60637

Email: mhammes@medicine.bsd.uchicago.edu