Application of the Buttonhole Cannulation Technique to Self-Cannulation in Home Hemodialysis～Consideration based on Changes in the Arteriovenous Fistula-related Infection Rate of Buttonhole Cannulation at our Clinic～

Abstract

The patients must puncture the arteriovenous fistula by self-cannulation in home hemodialysis in Japan. At our clinic, we have been taught the buttonhole cannulation technique using blunt needle as the first selected cannulation method to the patient who will be treated with home hemodialysis in training phase. We have been thought that arteriovenous fistula-related infection using buttonhole cannulation could be prevented by removing the scab at the puncture site and thoroughly sterile operation. The survey of arteriovenous fistula-related infection rates of home hemodialysis patients in our clinic revealed that it was higher than those of rope ladder cannulation or buttonhole cannulation in in-center hemodialysis patients. From the results, we reconsidered the application of buttonhole cannulation to home hemodialysis patients. Buttonhole cannulation technique is still an advantageous method for self-cannulation for home hemodialysis, but we believe that restrictions and conditions are necessary for its application to avoid the arteriovenous fistula-related infection.