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How Rocket Science May Improve Kidney Dialysis

Researchers perfect arterio-venous fistulae

Researchers in the United Kingdom have found a way to redesign artificial connections between arteries and veins (arterio-venous fistulae [AVF]), which surgeons form in the arms of people with end-stage renal disease so that they can receive routine dialysis.

The new design, described in the journal Physics of Fluids, may reduce the likelihood of blockages in AVF, which are a major complication of dialysis.

While the new method for creating AVF would have to prove effective in clinical trials before it could be deemed a success, the researchers are enthusiastic about their approach, which uses software from the aerospace industry to design the novel configurations.

“At the moment, the process of creating arterio-venous fistulae for dialysis is rather ‘one-size-fits-all’,” said Dr. Peter Vincent of the Department of Aeronautics at Imperial College London. “Our ultimate aim is to use computational simulation tools to design tailored, patient-specific arterio-venous fistulae configurations that won’t block and fail.”

Blood flow patterns within AVF are “inherently unnatural, and it’s thought that these unnatural flow patterns lead to their ultimate failure,” Vincent explained.

By using computational simulation software originally developed for the aerospace sector, the researchers were able to simulate and predict flow patterns in various AVF configurations.

The team “identified ways of constructing arterio-venous fistulae such that the flow is stabilized,” Vincent said. “We discovered that if an arterio-venous fistula is formed via connection of a vein onto the outside of an arterial bend, it stabilizes the flow.”

The implications of this work are tremendous, Vincent said, because it may now be possible to design AVF with reduced failure rates — offering improved clinical outcomes for patients with kidney failure who require dialysis.

Source:; March 17, 2015.

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