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Multidisciplinary working group: key role for percutaneous endovascular AV fistula program. Point of view

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Abstract

Chronic kidney disease is a progressive condition that affects more than 10% of the general population worldwide. Hemodialysis is the most common therapeutic option for kidney failure, which develops in around one out of 1000 individuals in the general population. Hemodialysis needs a vascular access to connect to the extracorporeal machine. In the last few years percutaneous endovascular arterio-venous fistula technique has been increasingly employed with very promising results. Several advantages have been demonstrated in comparison to the standard surgical creation of an arteriovenous fistula. The percutaneous endovascular arterio-venous fistula technique requires multidisciplinary team work. In our practice, we have organized a multidisciplinary team that includes nephrologists, play a key role, interventional radiologists, vascular surgeons, anesthesiologists, and dialysis nurses. Procedural outcomes and feedback received from patients and family members are evaluated periodically in order to improve results. Nephrologists are involved in each step of the management of the percutaneous endovascular arterio-venous fistula: selection, mapping, creation, and follow up. Patient empowerment, education and involvement is required at each step. A dedicated training program, involving patients and the caregiver team is therefore needed. Additional research is required to confirm the benefit of the multidisciplinary team management in end-stage kidney disease patients.

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Data discussed in this point of view paper are available upon reasonable request to the contact author.

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Acknowledgements

We would like to thank Margo Underwood for the precious support in the revision and editing of the article.

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No funds, grants, or other support was received.

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Authors and Affiliations

  1. Vascular and Interventional Radiology Department, “Careggi” University Hospital, L.Go G.A Brambilla 3, Florence, Italy

    Fabrizio Fanelli, G. Falcone, G. Gabbani & A. L. Annese

  2. Nephrology Dialysis and Transplant Unit, “Careggi” University Hospital, Florence, Italy

    I. Gianassi, R. Cutruzzulla, E. Dervishi & L. Cirami

Authors
  1. Fabrizio Fanelli
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  2. G. Falcone
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  3. G. Gabbani
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  4. A. L. Annese
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  5. I. Gianassi
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  6. R. Cutruzzulla
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  7. E. Dervishi
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  8. L. Cirami
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Correspondence to Fabrizio Fanelli.

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The article has been created without the use of human participants and/or animals. Data sharing Data discussed in this point of view paper are available upon reasonable request to the contact author.

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Fanelli, F., Falcone, G., Gabbani, G. et al. Multidisciplinary working group: key role for percutaneous endovascular AV fistula program. Point of view. J Nephrol 37, 215–219 (2024). https://doi.org/10.1007/s40620-023-01778-7

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  • DOI: https://doi.org/10.1007/s40620-023-01778-7

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