Fatal Dialysis Vascular Access Hemorrhage

Matthew D. Jose, Mark R Marshall, Gail Read, Nicole Lioufas, Jon Ling, Paul Snelling, Kevan R. Polkinghorne

Research output: Contribution to journalArticleResearchpeer-review

11 Citations (Scopus)

Abstract

Bleeding from dialysis vascular access (arteriovenous fistulas, arteriovenous grafts, and vascular catheters) is uncommon. Death from these bleeds is rare and likely to be under-reported, with incident rates of fewer than 1 episode for every 1,000 patient-years on dialysis, meaning that dialysis units may experience this catastrophic event only once a decade. There is an opportunity to learn from (and therefore prevent) these bleeding deaths. We reviewed all reported episodes of death due to vascular access bleeding in Australia and New Zealand over a 14-year period together with individual dialysis units' root cause analyses on each event. In this perspective, we provide a clinically useful summary of the evidence and knowledge gained from these rare events. Our conclusion is that death due to dialysis vascular access hemorrhage is an uncommon, catastrophic, but potentially preventable event if the right policies and procedures are put in place.

Original languageEnglish
Pages (from-to)570-575
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume70
Issue number4
DOIs
Publication statusPublished - Oct 2017

Keywords

  • Arteriovenous fistula (AVF)
  • Arteriovenous graft (AVG)
  • Central venous catheter (CVC)
  • Dialysis access
  • Fatal bleeding
  • Hemodialysis
  • Hemorrhage
  • Preventable death
  • Renal replacement therapy (RRT)
  • Vascular access complication

Cite this

Jose, M. D., Marshall, M. R., Read, G., Lioufas, N., Ling, J., Snelling, P., & Polkinghorne, K. R. (2017). Fatal Dialysis Vascular Access Hemorrhage. American Journal of Kidney Diseases, 70(4), 570-575. https://doi.org/10.1053/j.ajkd.2017.05.014