Infectious Diseases, Prevention and Control

Background: End-stage renal disease managed with haemodialysis requires vascular access commonly in the form of an arteriovenous fistula, arteriovenous graft or central venous catheter. Arteriovenous fistula and graft creation are associated with significant morbidity and mortality. Complications include thrombosis, stenosis, infection and haemorrhage. Literature Review: A literature review was performed using the Pubmed, Embase, Medline and CINAHL electronic databases from inception to December 2018 to identify cases of vascular access infection and fatal spontaneous vascular access hemorrhage amongst hemodialysis patients with an arteriovenous fistula or graft. These cases were examined to identify the relationship between vascular access infection and fatal exsanguination. Conclusion: Fatal spontaneous vascular access hemorrhage is a rare, yet preventable complication of hemodialysis that is not extensively described in the literature. Further research is required to enable more comprehensive risk profiling and develop optimal prevention and management strategies.