Use of internal arteriovenous fistula in home haemodialysis.

Five patients with previous experience of home haemodialysis (lasting one to two years) had internal arteriovenous fistulae created in a previously non-cannulated limb. After training of the spouses or patients to insert the needles, the arteriovenous cannulas were removed and the patients maintained on fistula dialysis in the home, unattended, overnight, for periods of 1 to 11 months (total patient experience of 30 months). All patients expressed a preference for the arteriovenous fistula, and no significant medical complications have been noted to date.The safe use of a blood pump in the home, overnight, was achieved by the addition of an extra monitor on the outflow (arterial) blood line.