ArticleKidney medicine2026
A Novel Single-Needle Distal Return Strategy Achieves Sustained Dialysis Efficacy and Eliminates Reinterventions in High-Risk Arteriovenous Fistulas.
Article in Kidney medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Rationale & Objective: Patients with arteriovenous fistulas (AVFs) facing recurrent interventions endure high procedural burdens and costs. We evaluated a novel single-needle distal return (SNDR) technique in refractory AVF cases to assess its impact on dialysis adequacy, reintervention rates, and economic outcomes. Study Design: Single-center retrospective self-controlled study. Setting & Participants: Twenty-five maintenance hemodialysis patients at a tertiary Chinese center (2021-2025) with AVF failure because of complete outflow occlusion (n = 6), venous hypertension (n = 8), procedural fatigue (n = 5), or inadequate cannulation length (n = 6). Findings: Over a median follow-up of 24 months, SNDR significantly improved dialysis adequacy (median single-pool Kt/V: 1.08 vs 1.46, Limitations: Single-center retrospective design and modest sample size limit generalizability. Conclusions: The SNDR technique not only sustained but improved dialysis efficacy while substantially reducing reinterventions, costs, and complications in complex AVF failure. This approach represents a transformative salvage strategy that substantially reduces costs before resorting to catheter-dependent options.
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