Mokhtar CHAWKI (nephrologist and Nephrokit's founder) & Olivier VALENTIN (sales director for the dialysis market)
The development of the first arteriovenous fistula (AVF) by Michael Cimino in the 1960s was an important milestone in the development and global spread of haemodialysis as a life-saving technique for hundreds of thousands of patients with end-stage renal disease.
This type of intervention, which consists of directly connecting an artery to a vein, results in a rapid increase in blood flow due to the pressure passing from the artery to the vein. Generally speaking, the flow rate of an arteriovenous fistula is on average 800 ml/minute and can in some cases reach 1500 ml/minute without cardiac repercussions!
However, this high flow rate is deleterious in the long term, particularly in diabetic and/or polyvascular patients.
This type of intervention, which consists of directly connecting an artery to a vein, results in a rapid increase in blood flow due to the pressure passing from the artery to the vein. Generally speaking, the flow rate of an arteriovenous fistula is on average 800 ml/minute and can in some cases reach 1500 ml/minute without cardiac repercussions!
However, this high flow rate is deleterious in the long term, particularly in diabetic and/or polyvascular patients.
The risk to elderly patients
Patients undergoing haemodialysis are increasingly older with a poor vascular network, which will encourage vascular surgeons to favour the creation of proximal AVFs (in the arm) at very high flow rates with inevitable cardiovascular risks. Moreover, because of their location, these AVFs are more difficult to access for post-dialysis compression.
The fragile skin condition of elderly patients favours the more rapid development of aneurysms and contributes to an additional difficulty in case of prolonged post dialysis bleeding (PDB).
The rapid development of blood flow over proximal AVFs in an elderly patient with fragile skin treated with anti-coagulants represents a real danger in the event of AVF needle disinsertion during the haemodialysis session or prolonged post-dialysis bleeding.
The fragile skin condition of elderly patients favours the more rapid development of aneurysms and contributes to an additional difficulty in case of prolonged post dialysis bleeding (PDB).
The rapid development of blood flow over proximal AVFs in an elderly patient with fragile skin treated with anti-coagulants represents a real danger in the event of AVF needle disinsertion during the haemodialysis session or prolonged post-dialysis bleeding.
The role of caregivers
The technical management of AVF during and after a haemodialysis session is the responsibility of nurses/paramedics.
Bleeding complications related to AVF are therefore often related to medical staff.
However, there are no precise recommendations for standardising AVF needle fixation, nor are there universal rules for optimising post-dialysis AVF compression.
Bleeding complications related to AVF are therefore often related to medical staff.
However, there are no precise recommendations for standardising AVF needle fixation, nor are there universal rules for optimising post-dialysis AVF compression.
NEPHROKIT's mission
NEPHROKIT has developed and marketed devices to improve and standardise the fixation of AVF needles as well as compression devices for haemostasis by physical effect.
Based on the knowledge of the company's founder Mokhtar Chawki and that gathered from the teams, as well as the scrupulous observation and systematic evaluation of practices, we have been able to identify the strong points for optimising AVF needle fixation and improving post-dialysis bleeding time.
Thanks to our expertise, we have been able to develop innovative medical devices with the primary intention of improving the life and comfort of dialysis patients. Nephrokit is also committed to making the actions of the nursing staff safer, faster and more efficient.
Based on the knowledge of the company's founder Mokhtar Chawki and that gathered from the teams, as well as the scrupulous observation and systematic evaluation of practices, we have been able to identify the strong points for optimising AVF needle fixation and improving post-dialysis bleeding time.
Thanks to our expertise, we have been able to develop innovative medical devices with the primary intention of improving the life and comfort of dialysis patients. Nephrokit is also committed to making the actions of the nursing staff safer, faster and more efficient.
