POS-658 Direct arterial puncture for hemodialysis, a neglected but simple and valuable vascular access

Because of the rapid growth of the aging population and the high prevalence of comorbidity, particularly diabetes mellitus, it’s really hard for patients undergoing maintenance hemodialysis (MHD) to create and maintain a well-functional arteriovenous fistula (AVF). Some patients exhaust their peripheral veins and do not retain the venous capital necessary for fistula creation, and some other with poor cardiac function can not afford the burden of arteriovenous shunt on the heart, even if their peripheral veins and/or arteries were available. Since a renal transplant is not readily available, patients virtually face death in the absence of dialysis therapy. Hence, it is critically important that VA is available to successfully receive the hemodialysis therapy. In China, direct arterial puncture (DAP) is chosen for 2-needles hemodialysis in some hemodialysis units to deal with the cases where arteriovenous access or catheter can not be established . DAP is used for the arterial line and peripheral veins or catheter is used as the venous line to return blood.