Cutaneous trophic disorders secondary to arteriovenous fistula for hemodialysis

The arteriovenous fistula is the vascular access of choice for hemodialysis treatment in patients with chronic renal failure. Clinical occurrence of local circulatory troubles caused by the fistula in addition to arterial robbery or venous hypertension are infrequent but may provoke serious consequences. Two patients with arteriovenous fistula with cutaneous trophic disorders secondary to the venous hypertension syndrome (case 1) and to the arterial robbery syndrome (case 2) are present. Prevalence, pathogenic factors, physiopathology, clinical aspects, and diagnosis and treatment of both syndromes are reviewed. Finally, the difficulty and morbidity of the creation of an efficient arteriovenous fistula in the diabetic patient is underlined.