{"id":101,"date":"2023-09-15T11:53:09","date_gmt":"2023-09-15T11:53:09","guid":{"rendered":"https:\/\/xsinnovations.rolandberger.amsterdam\/?page_id=101"},"modified":"2023-11-21T14:00:53","modified_gmt":"2023-11-21T14:00:53","slug":"the-need","status":"publish","type":"page","link":"https:\/\/xsinnovations.rolandberger.amsterdam\/?page_id=101","title":{"rendered":"The need"},"content":{"rendered":"

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End-stage kidney disease<\/strong><\/p>\n

End-stage kidney disease (ESKD) is often a result of a combination of problems, such as hypertension and diabetes mellitus, <\/span>and can be (partially) genetic.\u00a0As a result ESKD excess fluids and waste in the blood cannot leave a patient\u2019s body and cause serious health problems.\u00a0 Patients with ESKD require a lifesaving modality to replace kidney function and prevent mortality from the accumulation of waste products. Due to a shortage of donor kidneys available for transplant, most patients with ESKD depend on hemodialysis as kidney replacement therapy to stay alive.<\/span><\/p>\n

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Vascular access for hemodialysis
<\/strong><\/p>\n

The most common type of dialysis is hemodialysis. Using an \u201dartificial kidney\u201d called the dialyzer, a patient\u2019s blood is purified and the patient’s excess of water is removed. Critical to the process is a vascular access site where a high blood flow of minimum 600 mL\/min needs to be created to circulate the patient\u2019s blood effectively. The high blood flow can be achieved by surgically creating a shunt between a major artery and vein in the arm, which is called an arteriovenous fistula (AVF). The difference in pressure between the artery and vein creates a low resistance pathway for blood that promotes increased flow through these vessels. An AVF is the current golden standard for vascular access. When native vessels are not suitable, an arteriovenous graft (AVG) is used, which utilizes a graft made from synthetic material like polytetrafluoroethylene (PFTE). A central venous catheter (CVC) is often used for temporary access.<\/span><\/p>\n

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Complications<\/strong><\/p>\n

The high-flow vascular access site required for hemodialysis frequently causes serious complications. Among others, complications include:<\/p>\n