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I’ve always wondered what was happening with the intima of a vessel with higher pump speeds. I’ve questioned this for years for one particular reason.

We use to take transient patients from East Asia all the time. They would come in groups of 10 or more. Most had been on dialysis for years. They ran at pump speeds of 250 ml/min or less and none had aneurismal formation. Our patients run at 350ml/min or greater and all have some kind of aneurysms forming even with site rotation.

I attended a VA workshop in Toronto sponsored by St Mike’s Hospital. I forget the name of the Dr who spoke of the physics involved with jet streaming and how he theorized about the potential damaged caused to an access.

Have you ever wondered why a new access will spontaneously infiltrate, with no patient movement, after two or three hours of dialysis?


Rick Luscombe RN, BSN, CNeph©, VA CNL

Providence Health : this shows how lower pump speeds and longer dialyis effectes the out come of av/f, longer life and aneurismal formation. Stuart Mott

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