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NDT Advance Access originally published online on November 17, 2005
Nephrology Dialysis Transplantation 2006 21(2):254-257; doi:10.1093/ndt/gfi276
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Arteriovenous fistula after renal transplantation: utility, futility or threat?

Philippe Unger1 and Karl Martin Wissing2

1 Department of Cardiology and 2 Department of Nephrology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

Correspondence and offprint requests to: Philippe Unger, MD, Department of Cardiology, Erasme Hospital, 808 route de Lennik, B-1070 Brussels, Belgium. Email: punger@ulb.ac.be

Keywords: arteriovenous fistulas; left ventricular morphology; renal transplantation

The first 150 words of the full text of this article appear below.



   Introduction
 
Creation of an arteriovenous (AV) fistula for haemodialysis therapy provides convenient access to the circulation in patients with end-stage renal disease. However, the chronic volume overload induced by the AV fistula induces structural and functional cardiac changes, including left ventricular remodelling, which may be deleterious. The balance between the need for vascular access and the deleterious effects of a patent AV fistula on cardiac function and morphology obviously favours the former in patients requiring long-term haemodialysis. After renal transplantation, however, the value of keeping an AV fistula patent is more uncertain and whether it should be closed after successful renal transplantation remains a matter of debate. Since recent studies have provided more insight into the cardiac and haemodynamic changes induced by the procedure, this review aims to summarize the pros and cons of AV fistula closure.



   Determinants of left ventricular morphology after renal transplantation
 
Left ventricular hypertrophy is highly prevalent among patients with end-stage renal disease [1. . . [Full Text of this Article]



   Deleterious effects of AV fistulas
 


   Rationale for AV fistula closure
 


   Which patients should be considered for surgical closure?
 


   Conclusions
 

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[Abstract] [Full Text] [PDF]