We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Complications of Renal Dialysis Access Procedures

John E. Connolly, MD; Douglas A. Brownell, MD; Edward F. Levine, MD; P. Michael McCart, MD
Arch Surg. 1984;119(11):1325-1328. doi:10.1001/archsurg.1984.01390230091023.
Text Size: A A A
Published online


• The complications of 2,179 dialysis access procedures of various types have been reviewed in an effort to determine their possible prevention and management. Scribner arteriovenous shunts or central venous catheters were preferred for temporary dialysis. Infection was a common complication of central venous catheters, but responded well to removal of the catheter. Brescia-Cimino fistulae were preferred for longterm dialysis, but were often not possible because of inadequate veins or the need for relatively urgent hemodialysis. The most useful secondary shunt was the straight forearm synthetic polytetrafluoroethylene (PTFE) graft whose most common complication was thrombosis due to intimal hyperplasia at the venous anastomosis. In most cases, this complication could be corrected by patch grafting or by extension bypass. Infection was infrequent with PTFE shunts and, when localized, was sometimes successfully treated by drainage, antibiotic therapy, and topical povidone-iodine. The principal complications of long-term peritoneal dialysis were peritonitis and tunnel infection that responded to antibitoic therapy and/or removal of the catheter. Compulsive care in access insertion and meticulous management during dialysis has permitted very satisfactory long-term hemodialysis and peritoneal dialysis.

(Arch Surg 1984;119:1325-1328)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.