Vascular access for dialysis

Abstract

Since haemodialysis is now an established theraputic modality in Sri Lanka, the creation of vascular access becomes a relevant surgical topic. Of the 3 techniques available ie; shunts, fistulae, and large vein venepuncture, the former two have been practised by us. 15 shunts for dialysis of patients in acute renal failure were inserted. In 9 this followed snake bite. All except one were done under local anaesthesia. Clotting was the most frequent complication met with, (6 patients), with bleeding (2) and infection (I) being the others. For patients in chronic renal failure, 2 shunts and 4 radio-cephalic fistulae of the i Brescica/Cimino type were done. There were no complications, one fistula being used for haemodialysis as early as in the second week after construction. These papers also discuss the technical aspects of the surgical procedures.