Where can I find additional resources on the internet? National Kidney Foundation of Michigan National Kidney Foundation National Kidney Foundation Advisory on KDOQI Clinical Practice Guidelines The National Kidney Foundation has published 22 Clinical Practice Guidelines through its KDOQI process. These include recently revised and updated guidelines for the care of dialysis patients and a new guideline on anemia at all stages of CKD. At times, KDOQI guidelines have been utilized in the development of government policy to improve outcomes for dialysis patients. What is a fistula? A fistula is a vein that has been attached to an artery. The increased pressure and flow in the vein generally causes it to grow larger and tougher. When the vein is big enough, is can be used for dialysis. There are several types of fistulas (see the gallery of accesses). Can everyone have a fistula? In order to have a fistula, you must have a vein that can be developed, a good enough artery to supply the blood flow necessary, and a surgeon who is able to put the two together. Patients with very bad hearts or bad circulation may not be able to tolerate the strain of a fistula. What is a graft? A graft is a teflon tube used to connect an adequate artery (one big and healthy enough to provide decent blood flow) and a healthy outflow vein capable of handling at least 1000cc of blood per minute. These artificial blood vessels are used to "bridge" the gap between artery and outflow when the patients other veins have been used up. Currently in the USA, about 40% of patients dialyze using graft. Grafts are more prone to clotting and infection than fistulas, and the average lifespam of a graft (three years) is less than a fistula, so in general fistulas are more preferred when they are possible. However, a well-functioning graft may be preferable to a poorly functioning fistula. A well-functioning graft is much better than a catheter due to decreased risk of infection and lower risk of ruining the veins. A graft in the forearm is sometimes used as a temporary option to help develop the veins in the upper arm for fistulas later (see the Gallery of medical photos for examples of fistulas created from the outflow veins of grafts). The graft can be used in short order (getting the catheter out before it can cause damage to be veins), and own the line a transition from graft to fistula may be possible. What are the warning signs for grafts and fistulas? Achieving the DOQI Benchmark for Fistulas in Hemodialysis. The role of ultrasound in the creation of fistulas. Maturation of fistulas once created. Creating forearm fistulas above the wrist! Endovascular maintenance of dialysis access. The myth of "permanent access" and when to arrange for a shuntogram. Use of stents in hemodialysis access. A strategy to utilize our hidden vascular assets! Endovascular topics: Thrombolysis of AV grafts. Transposing the basilic vein.

Definitions: What is a Arm Loop Graft? What is a Forearm Loop Graft? What is a Left Arm Graft? What is a Straight Forearm Graft? What is a Wrist Forearm Fistula? What is a Transposed Basilic AV Fistula? What is a Elbow Cephalic Fistula?

Forms: Risk in Access surgery. Risk in Endovascular. Risk in Percutaneous thrombolysis.