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Vascular access for hemodialysis – past, present, perspectives

[Reviews]
Roman Kalinin; Igor Suchkov; Alexandr Pshennikov; Nina Mzhavanadze; Andrey Egorov;

The basic historical stages of the formation of ideas about permanent vascular access in patients with chronic renal failure are given, modern opportunities of hemodialysis are described, current problems and complications of renal replacement therapy are identified. The data about new developments in improvement of materials for vascular prostheses used in hemodialysis, as well as the search for a new (ideal) vascular access are presented. We have characterized the surgical and endovascular methods of correction and maintenance of the patency of permanent vascular access in hemodialysis patients. Methods of medical correction and prevention of complications of arteriovenous fistulas are described, including the standpoint of endothelial dysfunction and intimal hyperplasia, which will define new possibilities of conservative treatment at the stages of formation and existence of vascular access.

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Keywords: chronic renal failure, permanent vascular access, arteriovenous fistula, hemodialysis, endothelial dysfunction


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