Ever since the day of my arteriovenous fistula (AVF) surgery, I take particular care of my left arm to make sure nothing bad happens to the newly created AFV. Now imagine your fracture your arm - how about hemodialysis?
This exactly happened to a 45-year old man undergoing hemodialysis for 5 years.: he broke his left arm, thus requiring a cast for 6 weeks. In cases like this, the only options, it seems, is to go back to a central venous neck catheter to bridge the time until the fracture has completely healed and the cast could be removed.
Luckily, there is an alternative solution: by thinking 'out-of-the-box', MS Parmar from the Northern Ontario School of Medicine Sudbury and Thunder Bay (Canada) was able to convince the orthopedic surgeon to create a window in the cast to provide access to the AVF for hemodialysis. As stated by the author, the procedure exerted no negative effects on the patient's hemodialysis outcome.
Being the first report of its kind, the short communication published in Nephrology (Carlton) shows how an open discussion among the parties involved can result in innovative solutions with positive effects for us hemodialysis patients.
Source: MS Parmar (2019) Innovation in hemodialysis: Thinking 'out-of-the-box'. Avoiding central venous catheter in a maintenance haemodialysis patient following fracture of the arteriovenous access arm. Nephrology (Carlton), May 7.
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