REVIEW OF VASCULAR ACCESSES IN PATIENTS ON CHRONIC HEMODIALYSIS AND THEIR PROBLEMS OF LONG-TERM FUNCTIONING: THE CURRENT STATE OF THE ISSUE

Highlights Today, there is a wide variety of vascular accesses for hemodialysis sessions. For the first time, the main advantages and disadvantages of various types of permanent vascular access with prolonged use are described in a structured manner. Currently, the use of allographs and biological prostheses remains poorly understood, and their further study is a promising area. Absract To date, there is a wide variety of vascular accesses for hemodialysis sessions, including: dialysis catheter, primary or native arteriovenous fistula, arteriovenous grafts. The main problems of using permanent vascular access, leading to its loss, are revealed: excessive neointimal growth, infections, pulmonary hypertension, steal syndrome (stealing syndrome), aneurysmal dilation. The “gold standard” with the fewest possible complications is the use of native AVF. The dialysis catheter has many problems and is not recommended for long-term permanent use. The use of AVG from synthetic materials has long been described in many foreign studies and occupies an intermediate place among the approaches described above. Currently, the use of biotransplants (biological grafts) and allografts remains a little-studied alternative. Further study of the use of allographs and biological prostheses from the perspective of possible complications of permanent vascular access and comparison of the results obtained with native AVF and AVG will help to form a consensus on these materials among the scientific community.