Vascular Access and Self-Care Opportunities

More control over vascular access in dialysis can be an important part of dialysis self-care.

In addition to dialysis centers training patients to handle their own vascular access when motivated to learn, a new maker of venous access, Advent Access (Singapore), is positioning itself as a “disruptive” new technology that will further help patients on dialysis.

Advent Access’s “device-guided blunt access” proprietary platform aims to preserve AV fistula health and potentially allow hemodialysis centers to treat a larger patient population with fewer nurses or other support. The company’s subcutaneous access device is placed adjacent—but noninvasive— to an AV fistula.

When asked how Advent Access would disrupt current dialysis customs, founder Peh Ruey Feng in Singapore said, “We want to maintain the health of the AV fistula vein, preventing operator-related complications in the first place,” he told the (Singapore) Straits-Times newspaper. Reh said self-care among dialysis patients is possible, although the Achilles heel of self-hemodialysis has been managing vascular access.

Dialysis care providers like Diaverum (Munich, Germany; formerly Gambro) offer several steps of self-care and related training in their centers, including preparing equipment and supplies, placing the needle in the vascular access site, administering medication, monitoring the machine, and record-keeping.

DaVita noted that its patients and their caregivers can also learn and be trained to perform self-care tasks from washing the access site during care to self-cannulation.

Outset Medical’s (San Jose, CA) Tablo system is a standalone full-service dialysis unit that produces dialysate with tap water, rather than a central water treatment room, and completes blood processing. Patients can hook themselves up to the machine in about 10 minutes and as quickly as six minutes, according to Outset CEO Leslie Trigg.